Healthcare providers told federal lawmakers that Medicares private fee-for-service plans, or PFFS, severely undercut their ability to deliver quality, cost-effective care, and as a result, many of them are closing their doors to patients enrolled in such plans.
Albert Fisk, medical director at the Everett Clinic in Snohomish County, Washington, told members of the Senate Finance Committee that its network of physicians loses about $7.5 million a year because of its large base of Medicare patients, a portion of which can be attributed directly to private fee-for-service plans.
Since the private fee-for-service plans were the most (rapidly) growing part of our Medicare business, it became clear to us that we could not afford to continue to offer care under this program, Fisk said, adding that last fall, it had informed 1,400 patients that starting in 2009 they would not accept the PFFS plans.
Fisk, who was one of five people to testify in front of the influential committee, explained that many providers take a financial hit when they treat PFFS enrollees. He said that while PFFS plans get more federal dollars than traditional Medicare, the extra funding doesn't benefit providers. The Medicare Payment Advisory Commission said that Medicare spends 17% more on PFFS plans than it does on regular Medicare. Enrollment in PFFS plans has rapidly increased over the past two years, now totaling 1.7 million enrollees.
Unlike Medicare Advantage HMOs and PPOs, the private fee-for-service plans do not share cost of care and quality information with providers, Fisk said. -- by Matthew DoBias
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