Texas Doctors Dropping Out of Medicare

IN A MAJOR STORY LAST WEEK, the Houston Chronicle reported that the rate of Texas physicians who are dropping the Medicare program has increased 30-fold in 2010 compared to 2006. These findings indicate the level of “no confidence” that growing numbers of physicians have about the Medicare program.

The Houston Chronicle wrote that 50 physicians had opted out of Medicare in the first three months of 2010 and that more than 300 Texas physicians dropped the program in the previous two years. The Chronicle used data from Trailblazer Health Enterprises, the Medicare carrier for Texas, that included the number of physicians who had notified Trailblazer that they would no longer participate in the Medicare program. As recently as 2006, the Chronicle determined that only seven Texas doctors had opted out of providing for the Medicare program. The opt-out numbers were 70 in 2007, 151 in 2008, and 135 in 2009. Opt-out numbers between 1999 and 2002 were no more than three physicians opting out per year.

The Texas Medical Association (TMA) said that the Chronicle’s surprising numbers “far exceeded their assumptions.” In 2008, TMA had surveyed Texas physicians and learned that 42% of those doctors participating in the survey were no longer accepting new Medicare patients. The more disturbing finding was that, among primary-care doctors surveyed, the percentage of physicians no longer accepting Medicare patients was a stunning 62%!

Susan Bailey, M.D., President of the Texas Medical Association, told the Chronicle that “This new data shows the Medicare system is beginning to implode.” She attributed the growing number of physicians opting out to years of inadequate Medicare reimbursement, combined with the scheduled 21% cut in physician reimbursement that has yet to be fully resolved by Congress.

For pathologists and laboratory administrators, these numbers are an ominous portent. It is an early indication that greater numbers of physicians are prepared to cease serving Medicare patients in coming years, should Congress fail to maintain adequate levels of reimbursement. Of course, that begs the bigger point: where can Congress get the money needed to fund physician reimbursement at more generous levels? Confronted by physicians willing to cease serving Medicare patients, could that motivate lawmakers to possibly shift some of the future funding for Part A lab testing services over to physician services?


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