WASHINGTON, Sept. 7 (UPI) -- A survey issued this week by the American Medical Association shows most people would be blindsided by planned cuts to doctors' Medicare reimbursements, but when told of the pending pay decrease, a large majority are concerned it would hurt seniors' access to healthcare.
The AMA survey revealed that seven out of ten Americans surveyed were unaware that Medicare planned a five percent cut to Medicare reimbursements to physicians that would take effect in January.
"The vast majority of Americans didn't know that trouble is right around the corner," Bill Hazel, a Virginia-based orthopedist and member of AMA's board of trustees, said during a media teleconference Thursday.
An earlier survey by the group showed that nearly half of doctors surveyed said they would decrease the number of Medicare patients in their practices or stop seeing these patients altogether if the reimbursements are reduced.
The AMA survey released this week further showed that when told of the planned cuts, 86 percent of Americans were concerned that seniors' access to care would suffer if the pending reductions go through.
In addition, 93 percent of respondents ranging in age from 45 to 54 felt seniors' access to healthcare services would be affected by the cuts.
AMA released the survey results as part of a publicity blitz aimed at heading off the pay decrease set for January, which is only the first in a series of planned Medicare reimbursement cutbacks that the group says will total 40 percent over the next nine years.
"Congressional invention is the key" to stopping the threatened cuts, Hazel said, noting that AMA has gathered 80 senators' signatures on a letter calling for an 11th-hour reprieve, and is hoping lawmakers will make the bail-out a priority during the 30-day, pre-election congressional session.
He added that a number of AMA-member doctors would converge on Washington, D.C. in the coming days in a collective "house call" urging Congress to avert the cuts.
Hazel told reporters AMA is hoping for a payment freeze for the next year or two -- a move he estimated would cost Medicare between $11 billion and $13 billion dollars -- along with a two percent payment increase. The financial cost notwithstanding, "the cost of not acting is less access to care for seniors," he said.
However, Kirsten Sloan, national coordinator for health at senior advocacy group AARP, told United Press International that blocking the planned cuts could hurt seniors in another way -- hitting them with a higher Medicare premium.
If Medicare's physician reimbursements are frozen for another year, "Medicare beneficiaries would pay 25 percent of that cost in higher Part B premiums," she said. And this is nothing new, Sloan added. "For the last several years, there have been double-digit increases in Part B premiums in large part due to increaes in physician payments," she said.
In fact, the cost of last year's (Medicare payment freeze) has already been calculated into the premiums Medicare beneficiaries will pay in 2007, Sloan added. That number is already close to $100 per month, she said, and as premiums continue to rise, "It could price people out of the market."
What's more, Sloan said, the Part B premium is only the tip of the iceberg of expenses the typical Medicare beneficiary faces, which include Part D drug costs, the costs of supplemental insurance and cost-sharing expenses like deductibles, all of which could add up to $20 or more per month if Medicare physician reimbursements stay the same. "That's not an insignificant chunk of change to someone with an income of ($25,000)," she said.
But even if doctors manage to dodge next year's pay decrease, it would amount to only a short-term fix for doctors, AMA's Hazel said. "The main message is, the (current Medicare reimbursement formula) is a disaster. We need to compensate physicians for increases in their costs," Hazel said.
The current formula in place since 1997 -- known as the SGR formula -- ties Medicare reimbursements to the U.S. gross domestic product and reduces doctors' payments if they go over a certain volume of services.
"We must tie Medicare payments to practice costs," he said. Hazel said Medicare reimbursements to physicians has been frozen at 2001 levels, while inflation has climbed 15 percent since that time, and that doctors face unique expenses, including "sky-high" medical malpractice premiums, medical equipment purchases and the need to invest in health information technology, as healthcare converts to electronic medical records.
Hazel added that AMA supports integrating quality-based measures into a revised Medicare payment system, but that averting the pay cuts and fixing a "badly broken" reimbursement system must come first. He said that some of the 140 quality measures developed by AMA involve investment in health information technology, adding, "It's hard to make capital investments (in health IT) when the whole system is in a state of flux."
AARP's Sloan said her group doesn't endorse a "cost of practice" formula, but rather one based on "the quality of care provided," or simply put, a system that integrates pay-for-performance. "We want doctors to be paid fairly," she said, but Medicare beneficiaries shoud also get "value for their dollar."
