A Potentially Bad Summer for Patients

This could be a bad summer for patients if things stay as they are.

First off it appears that unless the Senate moves within the next day that Carriers for the Centers for Medicare and Medicaid Services (CMS) will begin processing two weeks' worth of suspended Medicare claims at rates reduced by 21.3% on June 15 unless Congressional Democrats change their timetable to avert the massive cut.

If legislative efforts to end the reimbursement crisis continue to stall, medical practices will have to decide whether to delay filing new claims until the pay cut is blocked or to submit those claims at the reduced rate and get them paid in full later. This means that some docs will possibly run into a cash flow problem and that will add to their increased reluctance to accept Medicare and Medicaid patients, according to a new survey by the American Medical Association (AMA).

The online survey of 9,000 physicians in May revealed that 17% -- and 31% of those in primary care -- are limiting the number of Medicare patients they treat, with most of them explaining that Medicare rates are too low and that the threat of future cuts "makes Medicare an unreliable payer," in the words of the survey.

The AMA released the survey today in tandem with the debut of an ad campaign urging Americans to pressure the Senate to address Medicare reimbursement when it convenes tommorow after a week-long Memorial Day break. AMA President J. James Rohack, MD, at a press conference last week said that temporary doc fixes would further reduce patient access to physicians in the Medicare program, according to the new AMA survey.

Even if Congress increases Medicare reimbursement over three to five years only to subject physicians to a 21% cut at the end, nearly half of all physicians --  48% -- would see fewer Medicare patients, 42% would turn away new ones, and 26% would not see any. Dr. Rohack said the possibility that physicians would abandon Medicare in large numbers has dire consequences in light of how the massive baby boom generation will begin to enter the program beginning in 2011.

Second, this is the time of year when new physicians go into practice and a recent study from the University of California found that hospital errors in the US peak in July. Thousands begin their medical residencies in July, and those first weeks may be a dangerous time for patients in teaching hospitals, suggest researchers.

The team analyzed 244,388 death certificates issued between 1979 and 2006 that listed medication error as the primary cause of death and found that fatal medication errors spiked during July only in teaching hospitals. "These findings provide fresh evidence for 1) re-evaluating responsibilities assigned to new residents; 2) increasing supervision of new residents; 3) increasing education concerned with medication safety," the authors said in a news release.

And third, it appears that Walgreens and CVS are at war and the losers will be the patients. CVS/Caremark (NYSE:CVS) announced they are eliminating rival Walgreens (NYSE:WAG) from their pharmacy-benefit manager network. This move comes after Walgreens had announced it was dropping out of CVS Caremark's drug-benefits network, citing CVS's promotion of prescription plans that require patients with chronic conditions to use either CVS stores or the Caremark mail-order pharmacy. This is just the start of a mess that means patients will have less choices when it comes to having a neighborhood pharmacist to care for them.