Health care
Costs of care putting strain on doctors
Zooming in
Due to the “Baby Boomers” generation aging into Medicare and increasing average life expectancy, an influx of the population is using the insurance option, according to TMA officials. Current funding calculations for Medicare reimbursement to physicians don’t account for how much it costs physicians to provide care, said Brent Annear, associate vice president of media relations and leadership advancement for the TMA. As such, in the Southern region of the United States, the number of corporate-employed physicians grew 40% and the number of corpo- rate-owned practices grew nearly 59% between 2019 and 2020, according to a Physicians Advocacy Institute report. “A lot of these doctors that were in private prac- tice, they’re choosing to potentially either retire or leave the field or join a larger organization because of the burden of arguing with insurance companies [for proper] reimbursement,” Venghaus said.
Local physicians have said increasing costs to run a practice alongside issues with insurance companies are contributing to doctors in the Austin area–and throughout the country– leaving private medical practices. Medicare is the federal health insurance used by people with permanent disabilities and the elderly. Congress must pass funding for different branches, and one of the biggest payouts is paying physicians to care for Medicare patients. Adjusted for inflation, Medicare physician payments declined 29% from 2001 to 2024, while the overhead costs increased, according to data from the Texas Medical Association. “Last year, and this year, Medicare gave pay cuts, and in the setting of record inflation that’s made it extremely difficult for many practices to stay financially viable,” said Dr. Brad Venghaus, owner of Thrive Medical
Nearly 4.6M people in Texas, or about 15% of the state, enrolled in Medicare plans 135 national and state organizations petitioning for national change in payout structure 29% decrease in physician payouts from 2001-24, adjusted for inflation
SOURCES: AMERICAN MEDICAL ASSOCIATION, HEALTHINSURANCE.ORG, TEXAS MEDICAL ASSOCIATION/COMMUNITY IMPACT
Clinic. “While the cost of care has gone up, our average salary for employees–we’ll call it support staff, for medical assistants and nurses and everything–has probably gone up somewhere between 20 and 25%.”
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