How Medicare Policies May Limit Access to Specialty Care

Medicare Policies Put a Cap on Spending

• Medicare determines ahead of time how much it is willing to spend on healthcare.
• If spending exceeds that amount, physician fees are adjusted downward in following years.
• Any over-spending accumulates over the years, and is made up with cuts in future years.
• Future physician payments will continue to decrease to compensate for the additional spending on new Medicare patients.
• At age 65, Americans become eligible for Medicare.
• Americans age 65 and older require more healthcare services (see chart).
• Between 2000-2020, the population of Americans 65 and older is projected to grow by 56%.
  • Source: U.S. Census Bureau, March 18, 2004.
• With greater demand on Medicare from a growing population of Americans 65 and older, Medicare must continually reduce physician payments in order to stay within its spending limits.
• As Medicare continues to cut physician payments, fewer physicians will be economically able to treat Medicare patients.
• Fewer physicians treating more Medicare patients will create delays in treatment and waiting lists for doctor appointments.

Source: National Health Interview Survey, Person Sample, 2005

Note: Data for 2010 - 2050 are projections of the population.
Reference population: These data refer to the resident population.
Source: U.S. Census Bureau, Decennial Census, Population Estimates and Projections.