Private practice docs are cutting off Medicare patients

The old model of a single doc running a practice is disappearing in America. Between the overhead and the reduced compensation, this model of health care delivery looks increasingly anachronistic.

When I started as an assistant professor at a medical school in 1987, there was a lot of money sloshing around. Patients and their insurance companies would pay a premium to be seen by docs in an academic health care practice. Managed care put an end to that, and the medical school from which I recently retired is struggling to stay in the black after many years of deficits.

At the other end of the food chain are private practice docs. As America ages, more and more of their patients are on Medicare (as am I). And the government is proposing to slash Medicare payments again. The only way to weather these cuts is through joining group practices, which can achieve an economy of scale.

“Will his independent practice be able to survive another Medicare payment cut? That's what Terre Haute, Indiana internist Pardeep Kumar, MD, wonders each day as the next round of cuts looms.

"We have to see," Kumar said in a phone interview. "We have around 40% of the population of patients that are on Medicare ... Our overall ability to sustain as a private practitioner is significantly under distress because of these cuts."

*snip*

“CMS is proposing a 2.8% cut in the Medicare fee schedule for the 2025 fiscal year, which would, if approved by Congress, come on top of a 1.69% cut in 2024. Often, Congress reverses the cuts, although this year they did so only partially. The cut is currently in limbo -- along with the rest of the federal budget -- now that Congress has passed a short-term budget deal keeping the government funded at current levels through mid-December, after the election.”

Our current model of healthcare in America is increasingly unsustainable. When will the physician community wake up to the reality of single payer, a model used by all the other industrialized nations on the planet? Meanwhile, people on Medicare struggle to find primary care physicians.

https://www.medpagetoday.com/practicemanagement/reimbursement/112273?xid=nl_mostcommented_2024-10-11&mh=eb71348a5ff6ae370cc6759bc5dc3300