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Osteopath: New federal board will worsen Oklahoma's doctor shortage

BY BRET LANGERMAN, D.O. Published: July 21, 2013

Oklahoma's health care providers are warning of an impending physician shortage. Many of the state's 626,000 Medicare beneficiaries could have a particularly difficult time accessing a doctor in coming years.

The Affordable Care Act established a federal panel called the Independent Payment Advisory Board (IPAB), which could compound the Medicare beneficiary access problem by making cost-cutting recommendations for Medicare next year. IPAB could create another hurdle for Oklahoma physicians in treating Medicare patients.

According to the law, if Medicare is projected to grow more than a half percent faster than the rest of the economy, it's up to IPAB's 15 presidential appointees to recommend Medicare cuts.

Because of IPAB rules, members are restricted in the sorts of reforms they can propose. Since the panel can't change Medicare's fee-for-service structure or eligibility requirements, can't change Medicare Parts A and B, and can't increase premiums, the only real cost-saving measures that IPAB can recommend are cuts to physician reimbursements.

Provider payment cuts are a serious threat to Oklahoma seniors. Across the United States, physicians are already paid 20 percent less on average for Medicare recipients than for private patients. And according to a survey of more than 13,000 physicians, more than half of practitioners already have, or are planning to, limit the access Medicare patients have to their practices. More than 12 percent have closed or are planning to close their doors to new Medicare patients altogether.

If payment rates are lowered further, even more Oklahoma doctors might not be as willing to accept patients. Given that this state already suffers from one of the country's worst physician shortages, this could affect Oklahoma seniors more than other states. To put this problem in perspective, roughly 16 percent of the state population is enrolled in Medicare.

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