Washington -- Medicare patients - many of whom have multiple chronic illnesses - face severe difficulty in receiving healthcare if Congress does not act to avert pending cuts to Medicare payments, according to first-hand reports from physicians who specialize in internal medicine released by the 125,000-member American College of Physicians (ACP). Concerns about the impact of the cuts on access-to-care were evident from the responses of almost 2000 internists who, in response to a request from ACP, completed a questionnaire on the impact of the cuts.

Medicare payments to physicians are scheduled to be cut by 10.6 percent on June 30, and by another 5 percent on January 1, 2009. "Most patients - and as America ages, those numbers will include more and more Medicare recipients - receive their care from small-practice settings with 10 or fewer physicians.

These physician practices are run like any other small business," said Jeffrey P. Harris, MD, FACP, president-elect of ACP. "Our members, internal medicine physicians, are concerned that the scheduled cuts will have such an adverse impact that many of them will be forced to close their practices or limit how many Medicare patients can be accepted."
The cuts are the result of the flawed formula used to calculate Medicare payments to physicians. ACP, the largest medical specialty association, is asking Congress to pass legislation that will stop the impending cuts to payments. The organization is also calling on Congress for a long-term solution to replace the current formula with a reimbursement formula that would provide for permanent, predictable, and positive updates to physician payments.

The reports from ACP members sought specifics from practicing internists about how further payment cuts would affect their practices and their patients. Although not designed as a statistically valid survey, each of the reports from internists in practice provides a "real-life" glimpse into how patients may be affected by the Medicare cuts. Internists, on average, treat 2,000 patients, with an average of 800 Medicare patients. Their candid answers give real stories of what the cuts will mean to patients.

Almost a third of the internal medicine physicians said they would discontinue seeing new Medicare patients if the 10.6 percent cut goes into effect.
"In my geographic area, as much as 50 percent or more of an internal medicine practice consists of Medicare-aged patients" said a practicing physician in Florida. "Our office gets dozens of calls each week for new Medicare patients wanting to establish care with our physicians.

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