"This means that the worst insurer (Medicare) reimburses in our geographic area at approx 50% of our asking price."

Adam,

Oh, the difference a state makes.....

We are in Maryland, which actally has the highest median household income in the country, as of 2009. Most of this income is the Washington DC/Baltimore suburbs. One would think insurance reimbursement would be fairly good in such a state.

Medicare is actually one of our highest payers. CareFirst, the local BC/BS plan, is comparable to Medicare. Most other private insurers are lower than Medicare.

I think, if I could say that Medicare was about 50% of a private insurer, I would think I died and went to heaven (at least financial heaven.)

The other disturbing trend is a marked increase in prior auths, for both meds and diagnostic studies (MRIs) since the first of the year. And while the prior auth, in the past, seemed to be "rationing by time", now we are getting rejections, sometimes after hours of staff time spent. And the insurers tell the patient "Your doctor can call and request a peer-to-peer review", so it becomes my fault.....

Sorry about the whine....

Gene

Gene Nallin MD solo family practice with one PA Cumberland, Md