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Survey: Docs report rocky relationship with payers


Doctors facing a changing practice environment are unhappy with most large health payers, according to the 2014 Medscape insurer ratings report.

Medscape, a Web resource for health professionals, polled 6,314 physicians representing 25 specialties in an online survey about the physician-payer relationship. All respondents were doctors working at a practice or facility in the United States that accepts health insurance reimbursement. The survey ran from July through September and had a margin of error of ±1.22 percent. Here are some key findings:

Eighty-four percent of respondents reported accepting Medicare while 65 percent accept Medicaid. In a troubling finding for healthcare reform, 12 percent of physicians reported dropping Medicaid patients within the past two years and 21 percent plan to do so in 2015.

For overall performance, doctors ranked Blues Plans, Aetna and Cigna the highest, though ratings for these companies were lackluster. And doctors ranked the performance 60 percent of large insurers as below average.

Though it sounds like a question from Match.com, doctors were asked for attributes they valued most in an insurer. Reimbursement rates, ease of doing business and frequency of payment denials led the list. No insurer aced these measures.

Physicians reported that 36 percent of their patients are covered through exchange plans, with which two-thirds of respondents reported having problems and another 29 percent reported "lots of problems." Doctors appeared to have difficulty with all insurers in this market. Thirty-two percent of respondents noted increases in patient counts due to healthcare reform.           

When asked for advice on dealing with insurers, some doctors were strongly negative. Twenty-two percent urged peers to be aggressive, telling them to "fight," "be tough," or "lawyer up." Another eight percent voiced despair or suggested leaving medicine, with imperatives like "quit," "pray," or "scream."  

For perspective on the overall findings, Medscape's report included comments by practice management consultant Judy Aburmishan, MBA. "A great unease has been building for years from the time when the doctor got paid directly by the patient to the current environment where there is so much complexity and no patient accountability," Aburmishan said. "It's a difficult system for physicians to comprehend and to operate inside of, and it's getting more and more difficult."      

For more:
- see the Medscape report and slideshow

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