Primary Care Docs Face Pay Cut
Written by Editor   
Sunday, December 06, 2015 12:00 AM

Many primary care practitioners will see the expiration of a health law program that has been paying them a 10 percent bonus for caring for Medicare patients. Some say the loss may trickle down to the patients, who could have a harder time finding a doctor or have to wait longer for appointments. But others say the program has had little impact on their practices, if they were aware of it at all.

The incentive program began in 2011 and was designed to address disparities in Medicare reimbursements between primary care physicians and specialists. It distributed $664 million in bonuses in 2012, the most recent year that figures are available, to roughly 170,000 primary care practitioners, awarding each an average of $3,938, according to a 2014 report by the Medicare Payment Advisory Commission.

Medicare generally pays lower fees for primary care visits to evaluate and coordinate patients' care than for procedures that specialists perform. The difference is reflected in physician salaries. Half of primary care physicians made less than $241,000 in 2014, while for specialists the halfway mark was $412,000, according to the Medical Group Management Association's annual provider compensation survey.

The effect the bonus program is larger on practices with more Medicare patients. Dr. Andy Lazris estimates 90 percent of the patients that his five-practitioner practice in Columbia, Md., treats are on Medicare.

The incentive program was an effort to address shortcomings in Medicare's system of paying providers mostly a la carte for services, which tends to undervalue primary care providers' ongoing role in coordinating patients' care.

The vast majority of nonpediatrician primary care doctors accept patients who are covered by Medicare, according to a national survey by the Commonwealth Fund and the Kaiser Family Foundation. But while 93 percent take Medicare, a smaller percentage, 72 percent, accept new Medicare patients. 

Only a quarter of those surveyed said they received a bonus payment; half didn't know the program existed.

Of physicians who were aware of and received Medicare bonus payments, 37 percent said it made a small difference in their ability to serve their Medicare patients, and 5 percent said it made a big difference. However, nearly half—48 percent—said it made no difference at all.


Source:  http://www.npr.org/sections/health-shots/2015/11/28/457148697/end-of-medicare-bonuses-will-cut-pay-to-primary-care-doctors