Medicare Blog

what issues may a physician face with medicaid/medicare patients

by Trace Prosacco Jr. Published 2 years ago Updated 1 year ago

It stands to reason that these populations would face inherent challenges related to cost, accessibility, and provider engagement when they get sick; however, these are only a few of the challenges faced by Medicaid patients.

Full Answer

Do Medicare patients have difficulty finding primary care physicians?

Although a number of surveys indicate that few Medicare patients (less than 18% nationally) have difficulty finding primary care physicians, much has been written criticizing the methodology of these surveys.

What are the biggest challenges facing Medicaid today?

Though it provides a vital safety net, Medicaid faces five big challenges to providing good care and control costs into the future: Controlling costs — Medicaid is one of the largest items in state budgets, although its beneficiaries lack political clout.

Are physician practices overwhelmed with Medicare?

These are all good things, but most physician practices are overwhelmed with all the requirements of participation in Medicare. Why are physicians hanging in there with the Medicare program?

How do Medicare and Medicaid fee reductions affect physicians'income?

First, only a fraction of a physician's caseload is normally devoted to public benefits patients. Where public participation on the physician's part is limited, the impact of Medicare and Medicaid fee reductions on income should be minimal.

What are the disadvantages of Medicaid?

Disadvantages of Medicaid They will have a decreased financial ability to opt for elective treatments, and they may not be able to pay for top brand drugs or other medical aids. Another financial concern is that medical practices cannot charge a fee when Medicaid patients miss appointments.

What are three problems that are created by the Medicare program?

Although there are many more, let me mention just three big problems with the current Medicare system: The current Medicare system makes fraud easy. The bookkeeping is broken. The problem resolution system is lousy.

Do doctors treat Medicare patients differently?

Many doctors try to help out patients who can't afford to pay the full amount for an office visit or the copay for a pricey medication. Now along comes a study suggesting that physicians in one Texas community treat patients differently, depending on whether they are on Medicare or have private insurance.

Why have many physicians started refusing patients who are on Medicare?

The short answer is "yes." Thanks to the federal program's low reimbursement rates, stringent rules, and grueling paperwork process, many doctors are refusing to accept Medicare's payment for services. Medicare typically pays doctors only 80% of what private health insurance pays.

What are the advantages or disadvantages to serving Medicare and Medicaid populations?

The takeaway Medicare Advantage offers many benefits to original Medicare, including convenient coverage, multiple plan options, and long-term savings. There are some disadvantages as well, including provider limitations, additional costs, and lack of coverage while traveling.

What are some of the biggest challenges with Medicare today?

Top concerns for Medicare beneficiaries: Part B, appeals and affordable medications. The top concerns of Medicare enrollees include navigating Part B, appealing Medicare Advantage (MA) denials and affording meds, according to an annual report from the Medicare Rights Center.

Do doctors prefer Medicare patients?

Ninety-three percent of non-pediatric primary care physicians say they accept Medicare, comparable to the 94 percent that accept private insurance. But it also depends on what type of Medicare coverage you have, and whether you're already a current patient.

Do doctors lose money on Medicare patients?

Summarizing, we do find corroborative evidence (admittedly based on physician self-reports) that both Medicare and Medicaid pay significantly less (e.g., 30-50 percent) than the physician's usual fee for office and inpatient visits as well as for surgical and diagnostic procedures.

Why do doctors not like Medicare Advantage plans?

If they don't say under budget, they end up losing money. Meaning, you may not receive the full extent of care. Thus, many doctors will likely tell you they do not like Medicare Advantage plans because private insurance companies make it difficult for them to get paid for their services.

What is the difference between Medicare and Medicaid?

The difference between Medicaid and Medicare is that Medicaid is managed by states and is based on income. Medicare is managed by the federal government and is mainly based on age. But there are special circumstances, like certain disabilities, that may allow younger people to get Medicare.

Can a doctor charge more than Medicare allows?

A doctor is allowed to charge up to 15% more than the allowed Medicare rate and STILL remain "in-network" with Medicare. Some doctors accept the Medicare rate while others choose to charge up to the 15% additional amount.

Why do doctors stop taking insurance?

Doctors may stop taking insurance if they believe the health insurance company isn't offering enough compensation. If a doctor stops taking your health insurance, you have a few avenues, including asking if the doctor will take a reduced fee or provide flexible payment terms.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 1 2 3 4 5 6 7 8 9