The American Medical Association has identified 22 states in which physicians will drop from Medicare if a proposed 21 percent pay cut is enacted, further threatening access to care for seniors.
AMA officials said they would like to see a permanent repeal of the currently flawed Medicare physician payment formula, scheduled to take effeft Jan. 1, 2010.
An AMA report, released Wednesday, identifies "patent access hot spots,"
or states where seniors are most likely to encounter physician access problems. They are Alabama, Arkansas, the District of Columbia, Florida, Georgia, Idaho, Indiana, Kentucky, Louisiana, Massachusetts, Mississippi, Montana, New Mexico, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, West Virginia and Wyoming.
"This new analysis shows that seniors' access and choice of physician is already threatened and bolsters the case for permanent repeal of the flawed payment formula that projects the Medicare cuts," said AMA President-elect Cecil Wilson, MD. "The Senate is considering legislation this week that lays the foundation to permanent repeal, and we urge Senators to pass the bill to preserve the security and stability of Medicare."
Sen. Debbie Stabenow (D-Mich.) has introduced S. 1776, the "Medicare Physician Fairness Act of 2009," which would create a pathway to permanent reform this year. AMA leaders said they have activated the organization's grassroots network of patients and physicians nationwide to call for passage of the bill.
For the report, AMA researchers analyzed state-level data on five measures of access and identified the top 15 states on each measure. The 22 hot spots are based on their ranking in the top 15 of at least two of five objectives, including:
- Practicing physicians per 1,000 Medicare beneficiaries.
- Medicare beneficiaries age 65 and over living below 150 percent of the federal poverty level.
- Estimated underserved population living in primary care health professional shortage areas.
- Hospital emergency room visits per 1,000 population.
- Percentage reporting not seeing a doctor in the past 12 months because of cost.
"Without repeal, physicians face Medicare cuts of about 40 percent over the next five years," Wilson said. "In two years, the baby boomers will begin to reach Medicare age, and they will expect access to high-quality medical care to stay healthy and active as they age. Physicians want to provide this care, but they need to know that Medicare will cover the cost of providing 21st Century medical care."
"The time for band-aid fixes that preserve access in the short-term but grow the size of future cuts is past," he added. "The U.S. Senate can help ensure that physicians can care for Medicare patients now and into the future through permanent repeal of the broken Medicare physician payment formula."