Medicare Reimbursement

The Issue: Seniors Can’t Always Obtain Adequate Health Care

Many physicians are leaving or closing their doors, in part, because state and federally funded programs, such as Medicare for seniors, pay physicians well below the actual cost of care. The government pays physicians who treat Medicare patients 20-30 percent less than ten years ago and yet has increased required paperwork.

Low reimbursements reduce access.

Because reimbursements don’t come close to covering the real cost of care, many physicians are forced to stop accepting Medicare patients or shut down their practices. Each time a physician leaves, about 2,000 patients must find a new caregiver. Remaining doctors are overloaded and can't accept new patients. Medicare patients who cannot get care from a regular provider often seek more expensive care in already overcrowded hospital emergency rooms, further driving up health care costs.

Medicare payments vary geographically and are unfair to people in Washington state.

Based on a complicated, long-used formula, Medicare pays Washington doctors less than it pays the doctors of 41 other states. The federal government pays an average of $4,800 annually per Medicare patient in Washington State. The national average is $7,000 per patient. Washington D.C. gets $10,000 per patient. Seniors in Washington should not be treated differently just because of where they live. Our Congressional delegation is working on this issue, but they can’t do it alone. We all need to get involved and demand fair Medicare funding.

What are the answers?

While there are no easy answers, change will only happen if patients demand solutions from our policymakers. Some key areas of concern:

  • Increase the level of Medicare reimbursement to at least the actual cost of service.
  • Provide equality in Medicare payments among all states.
  • Decrease the incredible amount of paperwork required for Medicare procedures.
What can you do?

You can make a difference by keeping informed about important health care issues and writing to your Elected Officials. Let them know that health care funding is important. We’ve developed a Sample Letter that you can send directly to your elected officials or you can add a personal touch to the letter before sending it. Your voice needs to be heard. Learn more about how to Get Involved.

How can I make a difference?