02/04/2000

MEDICARE AND ITS IMPACT ON PATIENT
CARE

AAPS SURVEY OF PHYSICIANS

REPORT, CONCLUSIONS & SURVEY QUESTIONS

CONCLUSIONS:

1. INCREASING FEAR OF PROSECUTION OR GOVERNMENT RETALIATION HAS HAD A NEGATIVE IMPACT ON MEDICARE PATIENTS' ACCESS TO DOCTORS AND THEIR ABILITY TO RECEIVE CERTAIN SERVICES SUCH AS SURGERY:

• Almost 25% of doctors refuse to treat new Medicare patients;
• 20% of those who refuse to accept new Medicare patients, do so because of hassles and/or threats from Medicare carriers;
• More than one-third of doctors have trouble finding referral doctors for Medicare patients;
• More than one-third of doctors surveyed are restricting services to Medicare patients;
• Almost one-fifth of doctors give Medicare patients a lower priority for appointments;
• More than 80% of doctors have an increased fear of investigation or prosecution;
• More than one-fourth of doctors are restricting services to Medicare patients because of hassles/threats from Medicare.

2. COMPLIANCE WITH MEDICARE REGULATIONS TAKES A SIGNIFICANT AMOUNT OF DOCTORS' TIME AWAY FROM PATIENT CARE

The cost of compliance with regulations is high--

• Doctors and their staff spend a full one-fifth (22%) of their time on compliance issues. It costs an average of $14.70 to process a Medicare Claim, vs $11.15 for a private claim -- more than27% more.

3. UNRESTRICTED PRIVATE CONTRACTING UNDER MEDICARE WOULD GREATLY INCREASE DOCTORS' WILLINGNESS TO TREAT MEDICARE-ELIGIBLE PATIENTS;

• More than 63% of doctors would be willing to serve Medicare Patients if private contracting was expanded.,

4. THE FEDERAL GOVERNMENT'S INCREASED ROLE IN MEDICINE AND INCREASED FRAUD EFFORTS ARE LIKELY TO RESULT IN MORE DIFFICULTY FOR ALL PATIENTS TO ACCESS CARE, NOT JUST THOSE WHO ARE MEDICARE-ELIGIBLE.

Our survey shows that many doctors are planning to retire from practice with all patients much sooner than expected.

• DO YOU THINK YOU WILL RETIRE FROM ACTIVE PATIENT CARE AT A YOUNGER AGE THAN YOU WOULD HAVE CONSIDERED 5 YEARS AGO?

Yes	66%
No	9%

• If so, why?
  Increased government interference in the practice of medicine 66%
  Increased hassles with Medicare 63%
  Increased fear of unwarranted investigation or prosecution? 61%
  Decreased fees Medicare 56%
  And as a direct result of doctors' increased fear of investigation or prosecution, doctors are making changes in their practices that adversely affect patients

These are the actual questions and results of a national mailed survey sampling 331 physicians conducted in July 1999. Percentages have been rounded. Results for some questions may not add to 100% because of some not responding to specific questions, or in instances of allowing multiple answers to questions, where indicated.

WHAT PERCENTAGE OF YOUR PATIENT LOAD IS MEDICARE PATIENTS?

ARE YOU ACCEPTING NEW MEDICARE PATIENTS?

Accepting new uninsured patients?

IF NOT ACCEPTING NEW MEDICARE PATIENTS, WHY NOT? (all that apply)

ARE YOU RESTRICTING SERVICES TO MEDICARE PATIENTS?

If YES, which have contributed to that decision? (all that apply)

WHAT SERVICES ARE YOU RESTRICTING?

HAVE YOU EXPERIENCED DIFFICULTY IN FINDING A PHYSICIAN FOR A MEDICARE PATIENT WHO NEEDED A REFERRAL?

IN THE PAST THREE YEARS, HAVE YOU RECEIVED:

HAVE YOU OPTED OUT OF MEDICARE UNDER THE PROVISION OF THE BALANCED BUDGET ACT OF 1997?

WOULD EXPANDED PRIVATE CONTRACTING INCREASE YOUR WILLINGNESS TO SERVE MEDICARE PATIENTS?

ESTIMATED COST TO YOUR OFFICE:

DO YOU THINK YOU WILL RETIRE FROM ACTIVE PATIENT CARE AT A YOUNGER AGE THAN YOU WOULD HAVE CONSIDERED 5 YEARS AGO?

PRACTICING PHYSICIANS INVOLVED IN PATIENTS CARE AT LEAST 20 HOURS A WEEK

YEARS IN PRACTICE Average: 21 years

SPECIALTIES RESPONDING: