Health care in the United States is in perhaps one of the greatest periods of flux in history. Passage of the Affordable Care Act, with resultant regulatory changes, payment reductions and mandates, is making it increasingly difficult for physicians to maintain their practices and treat patients.
This is particularly true in a state such as New Mexico, where the very rural nature of our state and the lack of provider access present significant hurdles to physicians and patients alike.
Physician recruitment to our state is difficult, with retention being an even greater challenge.
New Mexico is one of the poorest states in the nation, with over 46 percent of its population enrolled in either Medicare or Medicaid. Physicians are not required to accept Medicare or Medicaid patients and very few believe she or he will be able to support a practice with only Medicare reimbursement.
It should be noted that the reimbursement a physician receives from both Medicare and Medicaid is low enough that, many times, physicians find themselves providing care to patients at or below their cost of providing the service. Providing such care is a reflection of their dedication to the profession and their commitment as physicians to be caregivers to patients.
While public reporting of Medicare payments made to physicians is a requirement of the ACA, the process is still in its infancy. The data in raw form tells only a very small portion of the overall picture.
Services for mid-level providers under a physician’s supervision are lumped under the physician’s name. Quality is not measured. Errors in the data are not accounted for. Payments made for drugs and supplies are lumped into the total reimbursement.
Physicians in specialties that naturally treat more Medicare patients are compared against physicians who rarely treat Medicare patients. The location where service is rendered is not considered, even though payments for facility-based care are generally higher than those for office-based care.
In the future, CMS should address the limitations of the current reporting system so that a more accurate portrayal of payment can be rendered.
Physicians must go through 10 to 14 years of school and training. The vast majority do what they do because they love it.
They make very difficult decisions every day that affect other people and society as a whole very directly; this can take a great toll on their minds and spirits.
Deciding what a patient is suffering from, making the precise diagnoses that guide treatment, prescribing the correct treatment, anticipating all the variables, rushing into emergent situations, saving lives, and preventing and curing disease are all a part of their day-to-day existence.
Is it so difficult to understand that these people are a positive force in society?
Thank you Dr. Thomas Ramage, Dr. Bishnu Rauth, Dr. Mark Chiu, Dr. Arthur Weinstein, Dr. Nyun Han, Dr. Michael Heeg, Dr. Terry Boulware, Dr. Aurelio Castrellon, Dr. Mark Bevan, Dr. Edgard Badine, Dr. Oladipo Adeniyi, Dr. Janet Bierley and all physicians in our state who care for Medicare patients every day. Your dedication and commitment saves lives, and is deeply appreciated.