Doctors Reject Patients Over Low ObamaCare Reimbursements

By:  Raven Clabough
08/07/2014
       
Doctors Reject Patients Over Low ObamaCare Reimbursements

As predicted, physicians have already begun to refuse patients with ObamaCare coverage because its plans have significantly reduced their reimbursements.

With a physician shortage already posing a problem for insured Americans, this will only exacerbate that dilemma.

During an interview with National Public Radio, Dr. Doug Gerard, a Connecticut internist, explained the impact that the federal healthcare plans would have on his practice. He related that a private insurer pays $100 for a typical patient visit, while Medicare's figure is approximately $80. ObamaCare's plan more closely mirrors Medicare payments — a situation that Gerard indicated would be unsustainable for his practice.

"I cannot accept a plan [in which] potentially commercial-type reimbursement rates were now going to be reimbursed at Medicare rates," Dr. Gerard told NPR. "You have to maintain a certain mix in private practice between the low reimbursers and the high reimbursers to be able to keep the lights on."

Gerard believes that ObamaCare will be similar to Medicaid, which has left many patients struggling to find physicians who were willing to accept it because of its low reimbursement rates.

"I don’t think most physicians know what they’re being reimbursed [under ObamaCare]," Gerard asserted. "Only when they start seeing some of those rates come through will they realize how low the rates are they agreed to."

Dr. Bob Russo, a radiologist and president-elect of the Connecticut State Medical Society, made similar comparisons.

"There's no question that Medicaid, under its old rates, wasn't working. So, have we just invented a new Medicaid that kind of slid the scale up a little more to make access a little more?" Russo asked.

Ken Lalime, CEO of Healthy CT, an insurance co-op, stated that insurers face the challenge of paying doctors enough while simultaneously maintaining low premiums.

"Every time you increase payments to providers, you have to offset that with increased reimbursements from the consumer," he noted. "So there's this balance between how much do you want to cost to provide that service and how much you can pass along in your premiums rates. It's a balancing act."

Of course, when reimbursements are set below what they would be in a free market, the quality of the care can be expected to be adversely impacted.

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