The Greatest Threat to Medicare and Medicaid Participation by Office-Based Physician Practices

• In Event: Management Accounting

Abstract

A significant portion of our nation’s health care services are supported by the government programs of Medicare and Medicaid, ensuring coverage for much of the population’s most vulnerable: the elderly, disabled, the young and low income. Signaling a possible accessibility issue on the horizon, a number of sources report that the proportion of U.S. office-based physicians willing to accept new Medicare and Medicaid patients is decreasing. Gaining insight into what the obstacles are and which proves to be the greatest threat to Medicare and Medicaid participation by physicians is worthy of exploration.

Drawing from a national survey of practicing physicians, this study examines five specifically identified financial pressures that make operating a practice a real challenge. Financial pressures represent reimbursement issues associated with revenue and various administrative concerns specific to cost. Friedman’s two-way analysis of variance by ranks is used to explore the problem of this study.

Findings signify that inadequate reimbursement is indeed the greatest obstacle in both Medicare and Medicaid participation by office-based physicians. This supports popular thought. Additionally however, it is found that timing of the revenue reimbursement as well as billing concerns over the paperwork requirements and filing of claims are a close second and as such should be considered a significant obstacle in physicians’ decision to accept new Medicare and Medicaid patients.

Author

• Christina J Bradbury, Plymouth State University