With the impending expiration of a 2011 incentive program, primary care physicians will stop receiving a 10 percent bonus for caring for Medicare patients. While some say the reduction in payments could adversely affect patients, others say the bonuses hardly had an impact on their practice, according to Kaiser Health News.
The incentive program was created to address disparities in Medicare reimbursement between PCPs and specialists. According to the Medical Group Management Association's annual provider compensation salary, the median salary for a PCP in 2014 was $241,000, while the median salary was $412,000 for specialists, Kaiser reported.
Other clinicians eligible for the incentive bonus include physicians who specialize in family medicine, internal medicine and geriatrics, as well as nurse practitioners and physician assistants.
Medicare's incentive program gave out $664 million in bonuses in 2012 to approximately 170,000 PCPs — an average of $3,938 per physician, according to a 2014 report by the Medicare Payment Advisory Commission, Kaiser reported.
Though not a major adjustment, the bonuses could be significant to a primary care practice. "It's not so much about the salary as it's about the practice expense," Wanda Filer, MD, president of the American Academy of Family Physicians, told Kaiser Health News. "Family medicine runs on very small margins, and sometimes on negative margins if they're paying for electronic health records, for example. Every few thousand makes a difference."
The impact of the bonuses is also more substantial for practices with a high number of Medicare patients.
The expiration of the Medicare incentive program trails the ending of a similar bonus program for Medicaid primary care services in 2014. Wayne J. Riley, MD, president of the American College of Physicians, predicts there will be some physicians who won't be able to take any more Medicare patients.
However, not all PCPs will miss the bonuses; only 25 percent of PCPs responding to a Commonwealth/Kaiser Family Foundation survey said they received a bonus payment, and half weren't aware the program existed. Of the physicians who were aware of and received the Medicare bonuses, 37 percent said they made a small difference in their ability to serve Medicare patients, 5 percent said it made a big difference and 48 percent said it made no difference at all.