Medicare beneficiaries are not having any trouble finding physicians to treat them, according to a new report from the Government Accountability Office.
In the report, released Monday, the GAO found that from 2000 through 2008, Medicare beneficiaries had sustained access to physicians participating in the program, with growing levels of service in some areas of the country.
The report follows controversy over physician access, with physicians facing a 21 percent cut in their Medicare reimbursement by January without Congressional intervention. President Barack Obama's proposed health reform plan has included overhauling how physicians are paid under Medicare by eliminating the threat of annual pay cuts and paying physicians for quality of care as opposed to quantity of care.
The American Medical Association and some members of Congress have argued that pay cuts are threatening beneficiary access, as physicians may choose to drop from Medicare. Experts have said the higher cost of healthcare in some parts of the country and rapid increases in spending for physician services could threaten the sustainability of the Medicare program.
Congress had asked the GAO to assess beneficiary access to physician services and identify indicators of potential over-use of physician services.
The GAO analyzed the most recent data available from several sources, including an annual Centers for Medicare and Medicaid Services survey of fee-for-service Medicare beneficiaries, Medicare physician claims for services provided in April of each year from 2000 through 2008, the Health Resources and Services Administration's area resource file and data from the U.S. Census Bureau.
GAO investigators found that Medicare beneficiaries experienced few problems accessing physician services during this time period. Only 3 percent of beneficiaries reported major difficulties accessing physician services in 2007 and 2008.
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The proportion of beneficiaries who received physician services and the number of services per beneficiary served increased nationwide from April 2000 to April 2008, according to the study. Indicators of physician willingness to serve Medicare beneficiaries and accept Medicare fees as payments in full also rose from 2000 to 2008.
Potentially over-served areas – areas that were in the top half in both the level and growth in use of physician services – tend to be in the more densely populated urban regions and the eastern part of the United States, the GAO found. Large metropolitan areas were much more likely to be potentially over-served than rural and small metropolitan areas, while areas east of the Mississippi River were more likely to be potentially over-served than those in the west.
Certain types of physician services, such as advanced imaging and minor procedures, were performed more frequently in potentially over-served areas relative to other areas, suggesting differences in physician practice patterns, GAO researchers found.
In commenting on a draft of this report, CMS officials said the report would help its longstanding practice of monitoring the effect of policy changes on beneficiary access to Medicare services.