The Association of American Physicians and Surgeons (AAPS, Internet aapsonline.org) has been encouraging and helping physicians and medical practices to drop participation in Medicare for quite a number of years now. Quite a few have done so (I'd guess most of those who did are in smaller cities and rural areas) and have reported that they enjoy their practices a lot more being free from some of the hassle of constant paperwork and disputes with government bureaucrats and appointed hacks over reimbursement. Not to mention the alleviation of the overall fear in the back of the participating physician's mind that some overzealous law enforcement official may turn a dispute over appropriate billing codes and reimbursement into a federal criminal case for alleged billing fraud; such things have been known to happen.
Obamacare would make things worse in terms of Medicare reimbursement for patient and participating physician alike. If ObamaCare is fully implemented, perhaps enough Medicare patients will decide to use non-participating practices where they know there will be significantly more out-of-pocket expenses but can be confident they will get more personalized attention from their physicians and faster, more reliable, higher quality care.
Good post. I most heartily agree with you. In November 2011, I was the target of a Medicare audit. It’s been almost a year later, and the auditors have yet to file a claim against me. In the mean time, I have had to spend 40 k and climbing on attorney bills, internal audits etc. This type of intimidation is at the very heart of 0bama and his totalitarian socialist regime. Since November, I have stopped seeing new Medicare patients, and I have released well over 70% of my existing Medicare patients. If 0bama is re-elected, I thinks it’s safe to say that Medicare audits and compliance will become even more dangerous and onerous in which case I will be done with Medicare. It will be foolish for small groups and solo practitioners to continue to see Medicare patients because of the very real regulatory risk, high compliance costs and low reimbursement. This will force Medicare patients to see providers in large hospital groups instead of small groups and solo practices which still comprise about 45% of physician manpower. Physicians are an able and adaptable group. Those remaining in private practice will gravitate towards other practice models; Boutique, cash pay, consultant work (IMEs, insurance), alternative medicine, personal injury/ legal cases. Some highly skilled specialists (neurosurgeons, orthopods, cardiac) may even be able to demand high fees per case as independent contractors for hospital groups that are unable to attract these specialists as employees. Still other physicians may be able to weather the regulatory risk, litigation risk and low reimbursement by running a stable of ‘mid levels’ (PAs, NPs) providing low quality cookbook care to patients on a medical assembly line.
BTW, AAPS is an excellent physician advocacy group and I am a member.