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Low Reimbursements


The Chicago Tribune had an interesting piece yesterday about how government plans reimburse doctors for their services. 

According to the story:

Though payments can vary depending on the service provided, it’s not uncommon for a physician to be paid $25 to $75 for a Medicaid patient’s routine visit. That can be 20 percent to 30 percent less than what the Medicare health insurance for the elderly pays and less than half the $100 to $125 or more a private insurer would pay for the same service.

The story uses this information to conclude that — despite President Obama’s entreaties on Thursday night for more doctors to enter primary care — low reimbursements from Medicaid are the reason that doctors choose specialties rather than joining the dwindling ranks of the general practitioners. The point is correct, but the story neglects a much larger point, which is that low reimbursement rates not only drive doctors away from primary care, but they can also drive doctors away from taking Medicare and Medicaid patients at all. 

A study last year in the Houston Chronicle found that “only 58 percent of Texas physicians are taking new Medicare cases, and only 38 percent of primary care physicians are doing so.” In addition, the study found, “[across] the country, only 600,000 of 1.5 million total physicians are currently willing to treat Medicare patients.” If doctors are already reluctant to participate in existing government run plans like Medicare and Medicaid, adding an additional public plan could discourage them even further.


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