At least 72 doctors in six states grossed more than $1 million each in 1992 from treating patients enrolled in the financially troubled Medicare program, according to a report published Sunday.
The report, by Cox Newspapers, showed the doctors had created efficient “assembly line” practices to process a high number of patients. One doctor employed a marketing director; another spent 10% of revenues on advertising.
Cox Newspapers performed a computer analysis of 100 million Medicare payment records in California, Arizona, Florida, Georgia, Ohio and Texas for 1992, the most recent year for which records are available. The analysis also found:
* About 2% of the doctors in each state surveyed were paid at least $250,000 apiece by Medicare.
* The rate of medical procedures among the elderly varied widely between counties, and areas where doctors aggressively marketed their specialties had higher rates of Medicare payments than surrounding counties.
John Eisenberg, director of the Georgetown University Medical Center and former chairman of a congressional advisory panel on Medicare, said doctors who gross $1 million or more annually are a “red flag” for the system.
“It would be an unusual physician who would bill and collect a million dollars a year from Medicare,” Eisenberg said. “The odds are that it would be worthwhile looking at his practice patterns, looking at his patient mix.”
But others defended the practices, noting that high patient volumes don’t prove doctors perform unnecessary surgery, and that as much as 80% of their Medicare revenues go to offset overhead.
“The fact that somebody bills us a lot, in and of itself, doesn’t suggest inappropriate service,” said Bruce Vladeck, administrator of the Health Care Financing Administration, which oversees Medicare.