Annals of Long Term Care

Doctors Seeing Fewer Medicare Patients Due to Threat of July 1 Medicare Physician Fee Cut; AGS Launches New Advocacy Campaign to Block the Cut
Nearly 25% of medical group practices responding to a recent national survey said they had either begun to limit the number of Medicare patients they treat or are not accepting any new Medicare patients, due to uncertainty surrounding Medicare payment rates, according to Congressional Quarterly’s “HealthBeat.”

The American Geriatrics Society (AGS) has launched a new advocacy campaign urging Congress to block the July 1 cut. For more information, and to join the campaign, visit www.healthinaging.org/advocacy/.

Nearly half of the more than 1000 practices responding to the recent Medical Group Management Association (MGMA) survey reported that the 10.6 % cut in Medicare physician payments scheduled to take effect July 1 had led them to stop accepting or to limit the number of beneficiaries they accept. Congress voted in December to delay for six months a mandated 10.1% Medicare physician pay cut scheduled to take effect January 1, and to substitute a 0.5% increase—setting the stage for the larger 10.6% cut slated to kick in July 1. Medicare's controversial Sustainable Growth Rate formula mandates cuts in Medicare payments to physicians when increases in these outlays exceed growth in Gross Domestic Product. Congress’ December vote to delay the pay cut followed sustained advocacy efforts, by the AGS, its members, and others, urging lawmakers to avert the cut and revise the process by which Medicare payments to physicians are determined.

Sen. Boxer Introduces Geriatrics Loan Forgiveness and Training Legislation in Senate, and AGS Endorses Bill; Washington Post Reports on Bill, Shortage of Geriatrics Professionals, and AGS’ Advocacy Work
To help alleviate the growing shortage of geriatrics healthcare providers, Sen. Barbara Boxer (D-CA) introduced legislation (S. 2708) on March 4, 2008, that would create a loan forgiveness program for professionals who complete training in geriatrics or gerontology and care for older adults for at least two years afterward. Her “Caring for an Aging America Act” would also expand training and advancement opportunities for long-term care workers. It would earmark $130 million in federal funds for the initiatives over five years.

The AGS, the National Council on Aging, the Alzheimer’s Association, and the Alliance for Aging Research were among the organizations working with Sen. Boxer on the legislation, and among the first to endorse it. AGS has long advocated for loan forgiveness programs for geriatrics healthcare providers.

An article about the loan forgiveness bill in the Washington Post, in fact, noted that AGS has advocated “aggressively” for measures such as Sen. Boxer’s, as well as for the Geriatric Assessment and Chronic Care Coordination Act (S. 1340) that Sen. Blanche Lincoln (D-AR) has introduced. The Post story reported the current shortage of geriatrics healthcare providers and added that the supply of these providers is “falling seriously behind needed levels.”

In its advocacy efforts on behalf of geriatric loan forgiveness, AGS has long noted that, given lower-than-market-rate Medicare reimbursement rates, a career focused on caring for older adults can be particularly financially unattractive for physicians with increasingly large medical school loan debts. A loan forgiveness program would provide the incentives needed to bring more providers into the field of geriatrics.

Under Sen. Boxer’s legislation, those eligible for loan forgiveness would be physicians, physician assistants, advance practice nurses, psychologists, and social workers who complete specialty training in geriatrics or gerontology, and who agree to provide care for older adults full time for a minimum of two years.