Low rates driving physicians from Medicare

It has long been the case that most physicians significantly limit their number of Medicaid patients. But flat or declining Medicare reimbursements are causing more physicians to reduce or restrict Medicare patients – to the point that it is difficult for a new Medicare patient to find a primary care physician in Wichita willing to see them.

Medicare payments to physicians were essentially flat for many years. Then last year, these payments were cut 2%, and this year an additional 3.4% reduction took effect. The net result is that, adjusted for inflation, the value of Medicare physician pay fell 30% from 2001 to 2024. This decrease was mitigated slightly this month when Congress passed a spending bill that included an immediate 1.68% increase in physician payments.

MSSC recently surveyed some primary care practices on whether they were currently accepting new Medicare or Medicaid patients. Few were.

Of the practices that responded to the point-intime survey, which represented 161 physicians, only 31 physicians were currently accepting new Medicare patients.

This total does not include the family medicine residency programs, whose faculty and residents accept both Medicaid and Medicare. Some of the practices surveyed see existing Medicare and Medicaid patients, and their physicians will continue to serve existing patients when they become eligible for Medicare. They just aren’t currently adding new patients.

Even with those accepting new Medicare patients, the availability may be limited. MSSC, which receives about 500 patient referral calls a year, had 120 in the first 10 weeks of 2024 from people looking for primary care physicians accepting new patients. Of those, 80 callers were covered by Medicaid/KanCare, 35 had Medicare, and 15 were on both Medicare and KanCare. One caller reported being told by a group that the earliest available appointment for a new Medicare patient was in December.

MSSC members Howard Chang, MD, Jany Moussa, MD, Aron Fast, MD, and Estephan Zayat, MD, visited with the health policy staffs of Kansas congressional members last month in Washington, DC. They advocated for reversing the current-year cut to Medicare physician fees.

They also argued for automatically adjusting the fee schedule based on the Medicare Economic Index. If physicians had received an inflationary adjustment as hospitals and other health professionals do, they would have seen a 4.6% increase in 2024 instead of a 3.4% cut.

The Kansas Medical Society also made a big push in Topeka this year for a significant increase in Medicaid rates. The House and Senate both included increases in their budgets. They should reconcile the final amount before the Legislature breaks in April.