Medicare, insurance exchanges & troublesome payers — 6 key notes for orthopedists in 2016

Practice Management

Health insurance exchanges, Medicare and low-reimbursing payers all have an impact on orthopedic practices.

Here are six key thoughts on how they affect orthopedic surgeons according to the Medscape Orthopedist Compensation Report 2016:

 

1. Around 82 percent of orthopedists reported not participating in health insurance exchanges in the past; only 18 percent said they did. But in 2016, the percentage of orthopedic surgeons who will take those plans jumped to 21 percent while only 34 percent gave a definite "no." Forty-five percent said they weren't sure whether they'd take exchange plans in 2016.

 

2. More than half of orthopedic surgeons — 53 percent — reported the health insurance exchanges didn't affect their income. Only 6 percent reported an increase and 41 percent reported a decrease.

 

3. Fourteen percent of orthopedists said they would drop insurers that paid poorly. Most said they wouldn't drop poorly-paying payers because:

 

• They need all payers: 17 percent
• It's inappropriate: 25 percent
• Not applicable: 43 percent

 

4. Fourteen percent of self-employed orthopedists plan to stop taking new Medicare patients this year and 5 percent said they would stop taking current Medicare patients. Most, however, plan to continue taking new and current Medicare patients.

 

5. Employed orthopedic surgeons are much more likely to accept new and current Medicare patients, with 82 percent — compared with 62 percent of self-employed orthopedic surgeons — who will take those patients. Only 7 percent of employed orthopedists said they'd stop taking new Medicare patients and 1 percent will stop taking current Medicare patients.

 

6. Only 30 percent of orthopedists report seeing a new influx of patients due to the Affordable Care Act. The other 70 percent haven't seen an influx of new patients.

 

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