Medicare is
an affordable and reliable federal-government sponsored program, which offers
enormous benefits to the patient, but rarely any to the physician. Imagine
going to a doctor for ages and you decided to opt-for Medicare, but your doctor
does not accept it. As shocking as it may sound, but a lot of doctors are
backing out of accepting Medicare due to a lot of problems.
In Medicare,
the doctor is supposed to accept Medicare-approved amounts for the services
that their patient avails, which only increases the burden on the patient. According
to the CMS stats, in 2012, about 9,539 doctors opt-out of the Medicare program
and the numbers are increasing day by day.
Increased Financial Burden
As per
doctors, the reimbursement rates of Medicare are very low and the program fails
to keep up with inflation. Apart from it, Medicare takes a lot of time to make
reimbursements and the delays affect the medical practice of the doctors. In
addition to this, an inquiry about the reimbursement can delay the payments for
up to several months. Medicare keeps on cutting the rates of reimbursement that
affects the earning of the doctors through performing procedures and office
visits.
Opt-Out of Medicare
Although a
lot of doctors are opting-out of Medicare, still a large number of providers
accept Medicare for adult patients. Due to a lot of troubles that the doctors
face with Medicare, many of them decide to opt-out of Medicare altogether.
These doctors might accept private insurance plans or in cases accept payments
from the pockets of their patients.
Increased Administrative Burden
Running a
medical practice is already difficult for doctors and insurance plans including
Medicare require them to fill a cohort of forms for each patient. The paperwork
can be extensive and the doctors might require staff to handle it along with
resubmissions, negotiating with the insurance companies, and handle the
resubmissions. Other methods of reducing administrative burden such as
Electronic Health Record (EHR) also cause problems for the doctors as there is
no standard EHR system.
Burnout of Physician
Being a
physician is not as simple as people's lives are on a stake; however, the
duties and extra work coming with Medicare are the first reason doctors
refusing Medicare patients. With low reimbursements, Medicare can significantly
affect doctors that are in private practice. It becomes extremely hard for
doctors to meet the increased demand for resources with limited income in their
hands. All these reasons combined lead to physician burnout, which is why many
doctors back out of Medicare and insurance companies.
Final
Words
From the
above discussion, the question ‘can doctors refuse Medicare patients’ can be
answered that yes, doctors can refuse Medicare patients. There are a lot of
reasons why physicians avoid Medicare patients, most of which is related to the
low reimbursements by Medicare. Keeping up with a medical practice with such
low payments is not quite possible for many doctors, which is why the government
needs to pay attention to these programs.
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