Transcript of " Will Doctors Opting Out of Medicare Affect the Affordable Care Act?"
Outsource Strategies International
Will Doctors Opting Out of Medicare Affect
Affordable Care Act ?
Will Doctors Opting Out of Medicare Affect the Affordable Care Act?
American physicians are bowing out of Medicare. This phenomenon has been blamed
on low payment rates and more and more rules with regard to medical billing and
coding and claims submission. The physicians that withdrew from Medicare in 2012
were thrice in number to those who began withdrawing three years ago. This finding
was released by the Centers for Medicare and Medicaid Services (CMS) which
administers the Medicare program. Another trend emerging is doctors reducing the
number of Medicare patients they handle without formally opting out of the Medicare
Medicare Becoming Less Popular Among Doctors
According to the CMS, 9,539 Medicare physicians had opted out in 2012 out of the
685,000 doctors who had enrolled. In 2009, the number of opting out physicians was
only 3,700. This is indeed the only time to date that CMS has published opt-out
On the other hand, according to a study conducted by the American Academy of
Family Physicians on its 800 members, 81% of family physicians had welcomed new
Medicare patients in 2012, a decrease from 83% of physicians who accepted in 2010.
The study also revealed that there was a 1% increase in family physicians who
accept only cash or are in concierge practices from the 3% of physicians in 2010. In
these practices, patients pay on a monthly or yearly basis to secure special
appointments with their physicians.
Senior Citizens Struggling to Find the Right Doctor
The Health Affairs journal published a study which claimed that 33% of the primary
care physicians in the country did not welcome new patients covered under Medicare
in the period from 2010 to 2011. This pulling out of Medicare by doctors has
significantly affected senior citizens according to Medicare Rights Center whose
patient-advocacy department has received many calls from the nation’s elderly
citizens complaining about their inability to find doctors who are interested in
treating them. These complaints are chiefly from the suburban and urban areas
where there will be patients willing to pay the doctor themselves if they do not
A lesser number of doctors have claimed they would not welcome new Medicaid
patients. There are a growing number of physicians who are not taking part in
contracts of private insurance companies as well.
Will the Affordable Care Act Fail to Influence?
But all this is happening at the wrong time since the new health law, Affordable Care
Act, is to give millions of American citizens more access to such insurance coverage.
According to health experts, there is no reason to panic since the doctors who are
opting out cannot make up the numbers required to make the Affordable Care Act
non-beneficial. However, it could cause inconvenience to patients as they would
either find it difficult to get physicians who will accept their new benefits or would
have to wait to get through to physicians who would accept their renewed and
increased health benefits.
Complex Regulations Make Claim Submission Difficult
One of the major reasons for doctors to shy away from government and private
insurance contracts may be the various minute regulations that are hard to keep
track of and the detailed medical billing and coding tasks, primary responsibilities
in medical claims submission, to be performed. Any minute fault in submitting claims
would result in non-payment for the potentially lifesaving care the physician has
provided to the patient. Delayed payments are a frustrating situation for physicians
and healthcare practices.
Outsourcing medical billing and coding to a reliable medical billing and coding
company can solve the problems physicians face and contribute to a healthier
(Article source: http://finance.yahoo.com/news/more-doctors-steer-clear-medicare030500979.html)