Medicare Participation Numbers Don’t Tell the Whole Story

A new report that says more doctors accepted Medicare patients last year than in 2007 is a bit misleading, says one rheumatologist.

An August briefing by the U.S. Department of Health and Human Services found that the percentage of all office-based physicians who report accepting new Medicare patients “has not changed significantly” between 2005 and 2012, rising from 87.9% to 90.7%. The report says findings should “allay concerns that the number of physicians ‘opting out’ of Medicare has increased in recent years,” but Herbert Baraf, MD, managing partner of Arthritis & Rheumatism Associates in Wheaton, Md., notes that just because doctors are accepting patients doesn’t mean they are treating them.

“I suppose that if one looks at a headcount of the number of doctors participating in the Medicare system, the number may be rising,” he says. “The amount of chair time available? I think that number is down … if you’re speaking to someone trying to make a phone call and trying to get seen by a doctor, there is a disconnect between the numbers that are quoted and the reality of how hard it is to find a primary care doctor.”

Dr. Baraf, clinical professor of medicine at George Washington University in Washington, D.C., says that less “chair time” for Medicare patients seeking primary care leaves rheumatologists and other specialists handling more duties that could otherwise be performed by others. That, in turn, leaves less time for the more specialized care some patients require.

He believes less physicians are treating Medicare patients in part because the new regulations—“unfunded mandates,” he calls them—have turned healthcare’s focus from good outcomes to hitting prespecified standards of care.

“The incentives and the polemics are all just misaligned from reality,” Dr. Baraf adds.

Richard Quinn is a freelance writer in New Jersey.

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