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Outsource Strategies International

Will Doctors Opting Out of Medicare Affect

the Affordable Care Act ?

Will Doctors Opting Out of Medicare Affect the Affordable Care Act? American physicians are bowing out of Medicare. This phenomenon has been blamed on low payment rates and more and more rules with regard to medical billing and coding and claims submission. The physicians that withdrew from Medicare in 2012 were thrice in number to those who began withdrawing three years ago. This finding was released by the Centers for Medicare and Medicaid Services (CMS) which administers the Medicare program. Another trend emerging is doctors reducing the number of Medicare patients they handle without formally opting out of the Medicare system. Medicare Becoming Less Popular Among Doctors According to the CMS, 9,539 Medicare physicians had opted out in 2012 out of the 685,000 doctors who had enrolled. In 2009, the number of opting out physicians was only 3,700. This is indeed the only time to date that CMS has published opt-out figures. On the other hand, according to a study conducted by the American Academy of Family Physicians on its 800 members, 81% of family physicians had welcomed new Medicare patients in 2012, a decrease from 83% of physicians who accepted in 2010. The study also revealed that there was a 1% increase in family physicians who accept only cash or are in concierge practices from the 3% of physicians in 2010. In these practices, patients pay on a monthly or yearly basis to secure special appointments with their physicians. Senior Citizens Struggling to Find the Right Doctor The Health Affairs journal published a study which claimed that 33% of the primary care physicians in the country did not welcome new patients covered under Medicare in the period from 2010 to 2011. This pulling out of Medicare by doctors has significantly affected senior citizens according to Medicare Rights Center whose patient-advocacy department has received many calls from the nation’s elderly citizens complaining about their inability to find doctors who are interested in treating them. These complaints are chiefly from the suburban and urban areas where there will be patients willing to pay the doctor themselves if they do not accept Medicare. A lesser number of doctors have claimed they would not welcome new Medicaid patients. There are a growing number of physicians who are not taking part in contracts of private insurance companies as well. Will the Affordable Care Act Fail to Influence? But all this is happening at the wrong time since the new health law, Affordable Care Act, is to give millions of American citizens more access to such insurance coverage. According to health experts, there is no reason to panic since the doctors who are opting out cannot make up the numbers required to make the Affordable Care Act non-beneficial. However, it could cause inconvenience to patients as they would either find it difficult to get physicians who will accept their new benefits or would have to wait to get through to physicians who would accept their renewed and increased health benefits.

Complex Regulations Make Claim Submission Difficult One of the major reasons for doctors to shy away from government and private insurance contracts may be the various minute regulations that are hard to keep track of and the detailed medical billing and coding tasks, primary responsibilities in medical claims submission, to be performed. Any minute fault in submitting claims would result in non-payment for the potentially lifesaving care the physician has provided to the patient. Delayed payments are a frustrating situation for physicians and healthcare practices. Outsourcing medical billing and coding to a reliable medical billing and coding company can solve the problems physicians face and contribute to a healthier America.

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Will Doctors Opting Out of Medicare Affect the Affordable Care Act?  
Will Doctors Opting Out of Medicare Affect the Affordable Care Act?  

The Affordable Care Act comes at a time when more and more physicians are opting out of Medicare and Medicaid. This article highlights some...