Whether to treat Medicare and Medicaid patients is often a difficult decision for providers, especially amid declining reimbursements.
By the end of 2023, several prominent orthopedic providers made the decision to go out of network with Medicare Advantage plans due a number of factors, including reimbursement rates dropping and new spine and orthopedic codes adding prior authorization requirements.
Here are 10 statistics on where physicians stand on Medicare and Medicaid patients in 2024, according to Medscape's 2024 "Doctors Evaluate Medicare and Medicaid Report," published July 12:
Note: Medscape surveyed 1,030 physicians in more than 29 specialties between Feb. 1 and March 19. Four percent of survey respondents were orthopedic surgeons while 2% were neurologists.
1. About 71% of physicians said they are somewhat supportive (23%), supportive (31%) or very supportive (17%) of continuing to treat Medicare patients moving forward.
2. About 6% of physicians said they are currently trying to limit the number of Medicare patients treated at their practices, while 76% said they are not.
3. Medicare reimbursement cuts have affected the majority of physicians, with 30% seeing a large effect, 47% seeing a moderate effect and 18% seeing a small effect.
4. A majority of physicians, 54%, report having a neutral experience dealing with Medicare in the past, while 38% have had an unfavorable experience.
5. A large majority of physicians said they find Medicare claims submissions to be complex, with 13% saying it is very complex, 35% saying it is moderately complex (35%) and 41% saying it is somewhat complex.
6. A majority of physicians said they see slow Medicare reimbursement times as a serious issue (18%) or moderate issue (46%).
7. The biggest challenge physicians said they face in regards to Medicaid is reimbursement rates (66%), followed by program rules (14%) and denied claims (9%).
8. The majority of physicians said they feel as though Medicaid reimbursement rates in their state are either low (37%) or very low (21%) compared to rates in other states.
9. The majority of physicians said they feel as though the amount of time states take to process Medicaid claims is either a serious issue (19%) or a moderate issue (49%).