Some worry about whether doctors will accept Medicare patients, but they should be more concerned about whether doctors will accept patients with private insurance. A new study, published in the Archives of Internal Medicine, found that 3% doctors stopped accepting new Medicare patients from 2005-2008, but that 93% were accepting new Medicare patients. Surprisingly, in that same time, only 88% of doctors took new patients with private insurance, 5.5% stopped accepting new private insurance patients. The thing is, who could blame them?
In Health Insurance – Profits, Benefits, Inefficiencies and Errors and in A Culture of Change, I talk about the interaction between doctors and insurance companies. In the former, I discuss research by the American Medical Association (AMA) showing that insurers are still wasting money, about $17 billion annually, by incorrectly processing more than 19%. With then Anthem Blue Cross Blue Shield processing more than 39% of claims incorrectly. As such, providers tare left spending an average of 10-14% of their operating costs dealing with insurance companies to resolve these errors. Again, time and money that takes away from patient care. In addition to the mishandled claims, the AMA also found that insurers were asking for many claims to undergo prior authorizations wasting more resources in administrative costs and delaying care. At least Medicare pays reliably (i.e. – fewer claim errors) (they also happen to be the largest payer).
In the second post, I talk about the burden we place on doctors to fill out forms and haggle with insurance companies. Their role becomes paper pusher instead of doctor. And on top of it all, they often have to take lower reimbursement rates. The entire “system” places a burden on physicians that they are no longer willing to accept.
And I think they’re right. They don’t get paid well or reliably and they are asked to do too much as we question their medical judgment.
Unfortunately, we already have a shortage of primary care physicians. We already have high costs and barriers associated with getting care and higher costs when patients can’t get care and have to go to the hospital. I’m sure doctors would love to see patients, but requirements mandated by private health insurance impedes their ability to do so. And surely it will only get worse when, under the Affordable Care Act’s mandate that everyone have insurance.
What then do we do? We have to insist on valuing the amount of work we ask our doctors to do. And we have to demand the system change.