While under some circumstances this "non-par" status could result in about an 8 percent increase in income, Orrico says surgeons might do it less to improve precarious balance sheets and more to send a signal to Washington, which closely watches Medicare participation rates to know if the system is working.

"[By non-participating or opting out,] they still feel they're living up to their commitment to treat the elderly and the disabled, but also demonstrate there are cracks in the system," Orrico says.


SGR fix failure

The Senate failed to pass a temporary fix of the SGR-based 21 percent Medicare payment cut to physicians before it adjourned for its two-week spring recess on Thursday, leaving some doctors feeling left out in the cold.

"It is hard to fathom how physicians will keep their doors open to MEDICARE and TRICARE patients when they are dealing with this kind of financial uncertainty," the American Medical Association President J. James Rohack, M.D. wrote on a Friday blog post.

When the Senate re-convenes April 12, many expect it to pick up debate on the bill, H.R. 4851, that would extend a delay on pay cuts until the end of April.

While the pay cut goes into effect on April 1, Medicare has announced a 10-day hold on processing claims to give Congress a chance to apply the cut delay when it meets again next month.

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