Why GIs aren’t dropping Medicare patients

Despite ongoing physician fee cuts from Medicare, some gastroenterologists are making the tough decision not to drop patients over declining reimbursements. 

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“My biggest concern over time is that this will begin to erode access for Medicare recipients to find physicians who will continue to accept new patients or will limit the number of patients from Medicare that they will see. The financial strain on practices will erode development of new services, expansion of care and may influence decisions to join an employment type of practice,” Stephen Amann, MD, a gastroenterologist at Digestive Health Specialists in Tupelo, Miss., told Becker’s in July. 

Three specialists told Becker’s their practices are not dropping Medicare patients despite constraints for physicians and a predicted erosion of care. 

Omar Khokhar, MD. Gastroenterologist at Illinois GastroHealth (Bloomington): Despite the reimbursement issue, we have an obligation to serve all patients equitably. Delayed diagnosis in this population often leads to downstream morbidity, which increases all-system burden.

Pankaj Vashi, MD. Department Head of Gastroenterology and Nutrition at City of Hope Chicago (Zion, Ill.): We are still accepting Medicare patients, but not Medicare Advantage patients. 

Pooja Singhal, MD. Gastroenterologist at SSM Health (Oklahoma City): My independently owned practice is still accepting Medicare/Medicare Advantage insurance plans. We continue to accept these plans because it is unfair to the patient to not have access to specialists and healthcare. Due to constantly declining reimbursements, oftentimes physicians and practices are taking a loss as compared to commercially insured patients by seeing Medicare patients. A large amount of the patient population is covered by Medicare plans. It will be unfortunate to exclude that patient population, but now emergence of direct primary care models may change this for the future.

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