Neurosurgeons may limit Medicare participation

National survey respondents say they might have to limit how many surgery services they provide to beneficiaries if payment rates don't improve.

By Chris Silva — Posted Feb. 24, 2010

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Neurosurgeons say they are very concerned about the current Medicare payment system and fear that beneficiary access will be affected unless the rate formula is fixed.

A national survey of about 680 neurosurgeons revealed that while most participate in Medicare, many have been or are considering limiting the scope of their involvement. Nearly 40% of neurosurgeons said that if payments continue to decline, they will see fewer new Medicare patients; 18% would not take any new patients. The survey results were released Feb. 10 by the American Assn. of Neurological Surgeons, the Congress of Neurological Surgeons and the Council of State Neurosurgical Societies.

More than half of neurosurgeons say they will stop providing certain services, and nearly 53% will reduce the time they spend with Medicare patients, the survey found.

"These results really do paint a bleak path we are going down," said Troy M. Tippett, MD, AANS president. "Many neurosurgeons in our survey indicated that if Medicare payments continue to decline, they would stop providing certain services, reduce staff, defer purchase of new medical equipment, reduce time spent with Medicare patients and begin referring complex cases elsewhere."

Over the past three to five years, neurosurgeons said they have encountered several key changes in the environment for Medicare patients, including:

  • Increased difficulty in referring Medicare patients to certain medical and surgical specialists (67%).
  • More physicians referring patients with complex problems (65%).
  • Beneficiaries who need to travel farther to obtain needed care (64%).
  • A reduction in the number of Medicare patients in neurosurgery practices due to low payments (59%).

Although the survey found problems nationwide, it concluded that Medicare patients in the Southwest were facing particular difficulties in finding neurosurgeons who could treat them.

The survey is available online (link).

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