On Friday evening, the Center for Medicaid and Medicare discretely released its 148-page report, calling for more cuts to the popular program. While the 3.5% proposed reduction is half of what industry insurers were expecting, some believe the rate could be higher.
“The payment reductions proposed yesterday are subject to negotiations with the industry and aren’t expected to become final until April 7. Insurers have predicted total cuts to the program, including additional adjustments, will be as much as 7 percent….
“The final cut may be bigger, as the proposed rate doesn’t take into account adjustments required by the Affordable Care Act,” Michael Manns, a Bloomberg Industries analyst, said in a telephone interview.”
What does this mean for already struggling seniors who’ve weathered last year’s cuts? If current trends continue, expect higher out-of-pocket costs, smaller networks, less doctors and possibly an increasing loss of plans. Texas resident Peggy has dodged most of these cost-cutting consequences, she wasn’t completely immune.
“I live in a small town with a limited number of doctors. Unfortunately, they – including my primary care physician – will no longer accept Medicare patients,” Peggy stated.
This phenomenon is happening across the nation. Physicians are fleeing, citing low reimbursement rates and burdensome regulations are forcing them to choose between their patients or their practice. Back in 2012, Forbes predicted how cuts to Medicare would drive doctors like Joseph Shanahan from the program.
“This spring, Shanahan [a rheumatologist in Raleigh, North Carolina] decided to stop taking new Medicare patients. “Not by choice,” said Shanahan, “but I’ve got to pay off the business loan I got, and I got to pay my staff, and I got to pay my malpractice insurance.” Shanahan reiterated what you hear from a lot of doctors: that they don’t want to stop taking new patients, but the government has left them no choice. “I don’t do medicine for the money,” he explained. “I never got into it to get rich. The real reward in medicine is taking care of patients and making them feel better.”
Two years later, that prediction is unfolding before our eyes. To keep her doctor, Peggy has to pay out-of-pocket – that is in addition to her Medicare Advantage premiums.
“If we want to continue having her services, then we [Medicare patients] would have to pay cash. She gave us a list of charges based on the time she spends on the appointment – for 3 to 5 minutes, it’s $55 and for 5-7 minutes, it is something like $65,” she explained.
“Even though I paid into Medicare for years as an employer, both for myself and for my employees, I’m now having to pay cash whenever I need to see a my doctor. This is unfair to me and all the people who paid into the program.”
The trend shows no signs of reversing. With more Baby Boomers entering the system over the next few decades, the tenuous system will become more strained, and Medicare cuts due to Obamacare are exacerbating the situation.
“It has changed the patient-doctor relationship tremendously,” Peggy said. “Now, when I look at my doctor, something is lost – it’s no longer a personal relationship; it is one of business. I go in, and I’m not going to stay any longer than I have to. There are some things I don’t get tested for, because I don’t want to pay all that money out-of-pocket.”
For seniors like Peggy, the cost goes beyond her pocketbook. You can’t put a price on the loss of the personal relationship between a doctor and a patient.
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