This content is sponsored by the American Medical Association.
The United States faces a major shortage of doctors, at a time when an aging baby boomer population increasingly is placing greater demands on the medical system.
Doctors are dealing not only with a surge in senior patients, but also with financial challenges in sustaining practices.
Bruce A. Scott, MD, president of the American Medical Association (AMA), described it as an “oncoming crisis” because the number of doctors can’t keep up with a growing senior population needing more care.
One study predicts a shortage of 86,000 physicians in the next 10 years.
At the same time, 45% of doctors are at least 55 years old, so they are reaching retirement age at a time when the demand for medical care is as high as ever.
While Scott said there are a lot of exciting medical advancements, doctors are dealing with a growing number of overwhelming hurdles.
“Physicians all around the United States are challenged by a spiral downward of reimbursements and a continued onslaught of increasing administrative burdens,” Scott said during WTOP’s The Health Care Agenda: Real Policies for Real People. “And all this is resulting in burnout among physicians, and frankly, some physicians are giving up.”
He said many are closing their practices, which is making it more difficult for patients to get care, especially in rural and underserved areas.
Medicare and inflation bubble
“Physicians right now are challenged, and one of the biggest challenges is that Medicare payments have actually gone down when adjusted for inflation by 29% since 2001,” Scott said. “Would you believe that?”
That means during the recent years of high inflation, doctors were effectively reimbursed less for Medicare than they were more than two decades ago. At the same time, physician expenses are rising.
“It’s not sustainable,” Scott said, which is part of the reason many physicians are closing their practices or cutting back.
Rep. Greg Murphy (R-NC), who is a doctor, echoed Scott’s concerns related to Medicare.
“What is happening now is that we see an environment of ever decreasing payment on the physician fee schedule, while you’re trying to keep your doors open,” Murphy said. “It’s becoming increasingly difficult in these times for private practices to survive.”
He noted that if a practice only took in Medicare patients, it would have to close its doors. The decrease in payments can force practices to considering restricting access to some Medicare patients too, he added.
“This trend cannot continue,” Murphy said.
Legislative reform on Medicare
Murphy and Scott say that the way the Centers for Medicare and Medicaid Services (CMS) calculates payments to doctors has needed reform for years.
“It all has to do with how CMS calculates utilization,” Murphy said.
He said changes are needed so that CMS can do a “smarter job in predicting where costs are going to be and where the over-predicted costs are going to be — to give some sense of stability to this entire system.”
Murphy is the sponsor of the Provider Reimbursement Stability Act, which would provide for adjustments to the physician fee schedule under Medicare. He said the legislation would expand the window related to CMS estimations developed for payment.
“Number two, we’re trying to give some sense to the predictability of these utilizations,” Murphy said. “Because I’ve seen CMS utilize or overpredict something by 80% plus or underpredict it by 15%.”
He said that needs to be accounted for in funding for the next year.
“This has not been changed since the early ’ 90s, and so we’re trying to set in the statute some predictability in a much better system, so that physicians understand how and what they’re going to get paid,” Murphy said.
Scott agreed. “We just want an inflation-based update, and to do that, we need congressional action, and we need that action now,” he said.
AMA: Patients, don’t remain silent
Murphy pointed out that close to 10,000 patients a day are being added to Medicare roles.
He said in 1965, when Medicare was created, there were about 4.5 people paying in for each recipient. Now, the number has decreased to about 2.5.
“We have to maneuver, we have to be smart, to make sure that our future Medicare patients and our present Medicare patients will have access to care,” Murphy said.
Scott said patients need to let their voices be heard in Washington. AMA encourages patients to go to its website, FixMedicareNow.org, and share their own experiences.
“Talk about the challenges that you’re having to get in to see your doctor. Talk to your legislators and let them know that it’s time to fix Medicare now,” Scott said.
Discover more articles and videos now on WTOP’s The Health Care Agenda: Real Policies for Real People event page.
