There are several reasons boomers, the 78 million Americans born between 1946 and 1964, could face difficulties finding a doctor if they retire to small towns over the next 20 years.
First, many primary care doctors prefer to live and work in urban areas because of greater cultural opportunities, better schools and job opportunities for spouses.
Also, Medicare pays rural doctors less per procedure than urban physicians because their operating costs are supposedly less. That makes rural doctors less likely to accept Medicare patients.
With cuts to Medicare reimbursement for doctors targeted under the federal health care overhaul, the shortage is likely to get even worse, said Mark Pauly, professor of health care management at the University of Pennsylvania.
That is, unless increasing reimbursements for nurse practitioners and physicians’ assistants encourages those providers to take up the slack, Pauly said.
If the Medicare cuts go through, “the doctors are saying: “We’re out of here,’” Pauly said. “The least they are saying is: ‘We’ll treat Medicare patients like we treat Medicaid patients,’ which is mostly not.”
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