Report cites lack of data on docs quitting Medicare

Results released from a report commissioned last year by HHS' inspector general's office found that limited data prevented researchers from drawing any conclusions about why physicians opt out of Medicare.

The results from Lack of Data Regarding Physicians Opting Out of Medicare (PDF), show the OIG failed to reach its original goal of finding why doctors chose to not participate in the program. Instead, it calls for more stringent CMS data requirements for physicians and non-physician practitioners who opted out Medicare after Jan. 1, 2009.

“Specifically, we cannot determine the characteristics of physicians who opt out of Medicare, the trend in the number of opted-out physicians, and why physicians choose to opt out of Medicare,” the report stated.

The OIG began in April and looked through a CMS-provided list of about 7,900 providers who have opted out between 1998 and March 2011. The report hypothesizes that the number of providers who opt out may be at 1% of all providers. Despite the small number, the report concludes it's important to track why those providers opt out and that the CMS should continue to monitor them to ensure Medicare patients have adequate access overall.

The researchers said they will move forward and conduct a full evaluation as initially proposed when the CMS acquires the proper data.