Home Forums Hunting & Shooting Hunter's Campfire 214,000 Doctors opt out of the hugely successful O bum mer care

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Over 214,000 doctors won't participate in the new plans under the Affordable Care Act (ACA,) analysis of a new survey by Medical Group Management Association shows. That number of 214,524, estimated by American Action Forum, is through May 2014, but appears to be growing due to plans that force doctors to take on burdensome costs. It's also about a quarter of the total number of 893,851 active professional physicians reported by the Kaiser Family Foundation.

In January, an estimated 70% of California's physicians were not participating in Covered California plans.

Here are some of the reasons why:

1. Reimbursements under Obamacare are at bottom-dollar - they are even lower than Medicare reimbursements, which are already significantly below market rates. "It is estimated that where private plans pay $1.00 for a service, Medicare pays $0.80, and ACA exchange plans are now paying about $0.60," a study by the think-tank American Action Forum finds. "For example, Covered California plans are setting their plan fee schedules in line with that of Medi-Cal-California's Medicaid Program-which means exchange plans are cutting provider reimbursement by up to 40 percent."

2. Doctors are expected to take on more patients to make up for the lost revenue, but that's not happening, because primary care doctors already have more patients than they can handle. "Furthermore, physicians are worried that exchange plan patients will be sicker than the average patient because they may have been without insurance for extended periods of time, and therefore will require more of the PCPs time at lower pay," says the study.

The study also points to two reasons that doctors might not get paid at all:

3. An MGMA study indicates that 75% of ACA patients that had seen doctors had chosen plans with high deductibles. Given that most of the patients are low-income, doctors are concerned that the patients cannot meet the deductibles and they will get stuck with the bill.

4. HHS requires that insurers cover customers for an additional 90 days after they have stopped paying their premiums: the insurer covers the first 30 - but, it's up to the doctor to recoup payment for the last 60 days. This is the number one reason providers are opting to not participate in the exchange plans. Currently, about a million people have failed to pay their premiums and had their plans canceled.

So, Obamacare is asking doctors to take on sicker patients for less money, with the risk of not getting paid at all? No wonder doctors are running from these plans!

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And it hasn't even really rolled out yet.

Pelosi

"we have to pass it to see what's in it"



what a surprise! What's in it is bad for John Q. Public


the freakin gov't doesn't run anything well and if they do it certainly isn't at cost effective levels


so hey here's a good idea, let's have them put their hooks in 12% of our GDP the medical industry


what could possibly go wrong?

Medicare folks have been struggling to find doctors before, just imagine what it's going to be like now!!! Or Randy, what you say, "what could possibly go wrong?"

I ran into an old friend last week. His son is a medical doctor. When I asked how is son is doing as a doctor he told me, "My son got into the electrical business because of Obama care."

had to see an old doc this week

he has two kids in college

the youngest is interested in the med field, maybe be a doc like her dad???

he says "I told her nursing is a better bet, if you really want to be a doctor go to vet school"

10-20 years there's gonna be a shortage of doc's most likely, we'll probably have plenty of lawyers though (grin)

The ACA is a big deal. It will affect health care in ways not yet seen. The 214,000 docs not participating should have been foreseen. The early retirements of people in their 50's and 60's will be another issue and is already occurring.

Unintended consequences.

Not a surprise.

This 214,000+ number is deceptive, though. It is mostly composed of private practice physicians who can make this decision quickly. The majority of the remaining primary care physicians are employed by corporate entities, most of which are not-for-profit. When these corporations start getting hit with 30% to 40% "discounts" from payors, they're going to go under in a short order or they'll have to opt out of the ACA plans. It will be an either/or situation.

What you'll see in less than 2 years is an overall increase in the number of people who have medical insurance, but their insurance will be useless outside of government clinics, which will be overwhelmed.

And that's just the outpatient/clinic side of things... hospitals are going to be closing at a record pace as their revenues dry up.

It's gonna get ugly, folks. I've been saying this since they pushed this piece of legislative suicide down our throats. Don't say I didn't tell you so way back.

Doc,
That sounds an awful lot like what I read it was like in the old Soviet Union. I didn't like it for them, and I don't think I'm going to like it for us.

I agree about what will happen with government clinics and and the hospitals and have said the same. Without serious revisions, our care - those who will be dependent on those sources of care - will be but a shadow of that of our parents' generation. What Doc Roc said seems inevitable; if so, there will be rationing in a myriad of ways - by rules, regulations, narrow defining criteria for a procedure approval, and attrition of those approved, queueing but waiting.

There is nothing mitigating about it. I doubt there is one in twenty that understands the ultimate effect the ACA will have particularly on the middle class.

I have gone from 25 patients/ day to 10, just due to the misery of Electronic Health Records.

Almost every doc that I work with make similar comments. They are not encouraging their children to follow in their footsteps.

Electronic Health Records (EHR's) can be good and they can be bad. I've been proactive in getting my EHR's in both hospital and clinic set up so that they're fast and efficient for me. I can produce a better, cleaner, more detailed chart note on my patients in my EHR than I ever could in the old paper charts, in about the same amount of time.

Unfortunately, that is my experience only, in the realms I have control over. My EHR's don't talk to each other... they can't. Different programs. And the quality of EHR's varies drastically, depending on who wrote the program and who implemented it.

When EHR's were mandated under Bush43, the requirements for performance of an EHR were based on outcomes, not on utility. What they SHOULD have done was have Dubya call up Steve Jobs and invite him to the White House, tell him what we wanted, then let him and his team design an EHR that could be used everywhere, a veritable iEHR.

Instead, we got this hodgepodge of homegrown systems that mostly don't work and consume enormous quantities of time on the part of healthcare providers. So rather than tending to our patients, we are forced to tend to our EHR.