Can anyone comment on this Forbes article re: MD's facing a 24% cut in Medicare/Medicaid rates?

[Scuba]

http://www.forbes.com/sites/merrillmatthews/2013/12/02/doctors-facing-a-24-pay-cut-in-both-medicare-and-medicaid-reimbursements/

Doctors seeing Medicare patients face a 24 percent cut in reimbursements beginning January 1. But almost no one has grasped that those cuts will hit Medicaid too—thanks to Obamacare. Unless Congress acts, we’re likely to see a huge exodus of doctors who will not accept either Medicare or Medicaid patients.

In 1997 Congress passed legislation, known as the “sustainable growth rate” (SGR), to try and reduce Medicare spending. If Medicare spending grew faster than a predetermined amount, doctors’ Medicare reimbursements would be cut the next year by enough to offset the overspending.

Not surprisingly, Medicare spending didn’t hit the target rate, and, again not surprisingly, Congress didn’t want doctors to take the financial hit. So Congress has passed legislation, known as the “Doc Fix,” multiple times to postpone the cuts and keep the reimbursement levels roughly the same.

But those postponed deficits keep piling up, and come January doctors will see, on average, a 24 percent cut in Medicare reimbursement levels. And here comes the double whammy: Medicaid reimbursements will face the same 24 percent cut.

Interesting that Forbes says "thanks to Obamacare" but clearly states it's a 1997 law (SGR) that's at play here.

[SickOfTheOnePct]

1. Until the ACA

SGR didn't apply to Medicaid, only to Medicare; I'm guessing that's where the "thanks to Obamacare" piece comes in.

They may lose doctors in many areas, but in areas with a large military or military retiree presence, not accepting Medicare means they can't accept Tricare either.

[dsc]

2. I read the whole article so you don't have to

Here is what the deal is. Before Obama care Medicaid paid 59 percent of what Medicare paid doctors. Under Obamacare, Medicaid reimbursement was increased to 100 percent of Medicare reimbursement. Now both will go down to 76 percent of Medicare reimbursement if nothing is done. In short, he is lying. The only thing Obama care did was increase Medicaid reimbursement.

[Scuba]

3. Do you have a source for this???

[dsc]

4. the article linked in the OP

that is what I read the whole thing refers to. It is spelled out in his article.

[Scuba]

7. Thanks. That's not how I interpreted the article, but your interpretation ...

... suggest Medicaid payments will actually go UP in the long run (from 59% to 100% of the Medicare rate, then down to 76%). See why I (and others) are confused?

[antiquie]

5. I'm really confused after reading this by KFF

The ACA Primary Care Increase: State Plans for SFY 2015

[SickOfTheOnePct]

6. Medicaid paid on average 59% of what Medicare paid

But states set their own reimbursement rates - there was no tie to Medicare reimbursement rates.

The ACA tied the two together, so when Medicare reimbursement goes up (or down) so does Medicaid. Prior to the ACA, that wasn't necessarily the case, as each state set their own reimbursement rates.

[truedelphi]

8. Except for the fact that the deal was - 716 billions of $$'s needed to be stripped out of MediCare

So the WH could offer up the idea that the new ACA provisions would not hurt our precious little deficit situation. (Which no government official ever discusses when the need for a new war or two appears - we suddenly have plenty to spend in terms of our military and war! )

This cut gets defended by Democrats who claim all this reduction does is cut some unnecessary fat out of the program. It is obvious to me that these people have never spent a day of their life dealing with actual doctors or actual clinics that treat MediCare patients. I know from my years as an elder care nursing assistant that way back in the 1990's it was hard if not impossible to find doctors who would take on new patients if the new patient was on MediCare.

Supposedly there are all these places "to cut' back on frivolities inside the MediCare program.

At one point in time, like way back in the 1980's there were some frivolities. I mean, I had a few patients who could get a visiting nurse just because they were lonely and wanted extra attention. (Although someone in the family or the Doctor had to spell out a "medical need" and pretend it was not just a case of someone getting more nursing as companionship.) That sort of thing is gone now.

I assume the editor at Forbes didn't do a good job of editing if indeed the piece of the information regarding the $ 716 billions of cuts was left out of the article.

[quadrature]

9. so how much are rates?

I give up. uncle.

how much?
is it some top secret?
why is it a secret?

[johnnyreb]

10. More comments please, from anyone knowledgeable.

Thanks.