Where Is Medicare Headed?

Lea Chatham September 12th, 2013

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It seems the reports of Medicare’s demise have been exaggerated. Those who thought that Medicare might be going the way of dinosaur may be surprised to learn that a recent brief compiled by the Department of Health and Human Services (HHS) indicates that not only is Medicare going strong, but more physicians are accepting Medicare today than in 2005. In 2012, 90.7% of office-based physicians reported accepting new Medicare patients compared to 87.9% in 2005.

The 2013 Great American Physician Survey, conducted by Physicians Practice and sponsored by Kareo, found similar results when it surveyed nearly 1,200 physicians. Only 19% said that they didn’t accept Medicare at all. A small percentage were closed to new patients or considering dropping Medicare in the future, but the majority were still accepting new Medicare patients and planned to keep doing so.

The HHS brief also found that the number of providers accepting new Medicare patients was equal to or even a little higher than those accepting new patients with private insurance. This may not be surprising since Medicare enrollment is increasing as baby boomers reach the qualifying age and enroll in Medicare at rates higher than ever before.

Despite the fact that physicians continue to accept new Medicare patients, some experts believe that there are still challenges for physicians that can create barriers for patients. “Payment rates may be stingy compared to private reimbursements, but few physicians can afford to disengage from Medicare,” David Howard, PhD, associate professor of health policy and management at Emory University in Atlanta, said in an article in MedPage Today. “It covers too many people (46 million) and there are too many dollars at stake (over $550 billion).”

The unfortunate result according to the article is that physicians may be accepting new patients but limiting how many appointments they have open for Medicare patients. This can mean longer wait times—a higher number of Medicare patients said they had an unwanted delay in getting an appointment according to the HHS brief.

A recent survey from Black Book Rankings presented insight into what the solution might be—seamlessly integrated practice management, electronic health records, and revenue cycle management solutions. This poll surveyed 8,000 physicians and medical professionals and found that 87% of all physician practices agree their billing and collections systems/processes need upgrading and 89% of those state a preference for a single source vendor for all RCM PM and EHR modules.

The fact is that by streamlining practice management, billing, and EHR, practices can potentially increase the number of patients they can see in a day and see an annual increase in overall collections of 11% according to the Medical Group Management Association.

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