WASHINGTON — Even though Medicare has only increased payment to physicians by an average of 0.5% per year in recent years, it doesn’t seem to have affected Medicare beneficiaries’ access to care, according to a Medicare Payment Advisory Commission (MedPAC) survey.
MedPAC staff regularly survey a sample of Medicare beneficiaries and privately insured patients to determine whether they are having problems getting to see a physician. In the latest survey, about 30% of Medicare beneficiaries who were looking for a new primary care physician in 2017 reported either a big or a small problem in finding a doctor, compared with 40% of privately insured patients seeking a new doctor, MedPAC senior analyst Kate Bloniarz reported on Thursday….
Interesting isn’t it. The question is what could this mean for a Medicare for All scheme? It would appear that physician’s are willing to trade lower fees for the volume of Medicare and the ease of reimbursement. But, of course, some of that fee loss is offset by the higher private sector fees.
The question is what will happen when the low fees are coupled with closer claim scrutiny, prior authorization, etc. almost certainly necessary in some manner to manage the budgets when out-of-pocket costs are removed under M4A.
Kathy Buto, MPA, a health policy consultant in Arlington, Va., wondered why patients with higher-reimbursing private insurance had more problems than Medicare beneficiaries in terms of accessing care. “Do we know what those factors are? Is it narrow network? If [patients of] high-paying insurers are not getting good access, what are we after here?”
Part of the answer may be that Medicare is an easier insurer to deal with than some private payers, Bloniarz said. “Medicare fee-for-service is quite popular because there’s usually no prior authorization or step therapy, and it’s any willing provider. I think that has a fair bit to do with it.”