NCMS SGR Survey

1.Do you currently treat patients in an active medical practice?
2.Are you currently accepting any new patients?
3.For patients covered by Medicare, does your practice currently (1) accept all new patients, (2) limit new patients that you will accept, or (3) accept no new patients?
4.As a result of the proposed 29.5-percent cut in Medicare fee schedules, what actions are you taking, planning or considering?
Have Done
Will Do
Considering
Will Not Do
Not Applicable
Place new or additional limits on Medicare acceptance
Accept no new Medicare patients
Terminate existing Medicare patients
Change status to Medicare nonparticipating
Formally opt out of Medicare and require direct payment
Place new or additional limits on Medicaid acceptance
Reduce the amount of charity care that I deliver
Increase standard fees charged to other patients
Delay information technology implementation
Renegotiate or terminate some health plan contracts
Close or sell my practice
Look for an employed position
Seek a nonclinical position
Retire
5.If Congress tries to compromise by offering a 10-percent cut in Medicare fee schedules, which actions would you take or consider?
Will Do
Will Consider
Will Not Do
Not Applicable
Place new or additional limits on Medicare acceptance
Accept no new Medicare patients
Terminate existing Medicare patients
Change status to Medicare nonparticipating
Formally opt out of Medicare and require direct payment
Place new or additional limits on Medicaid acceptance
Reduce the amount of charity care that I deliver
Increase standard fees charged to other patients
Delay information technology implementation
Renegotiate or terminate some health plan contracts
Close or sell my practice
Look for an employed position
Seek a nonclinical position
Retire
6.Approximately what percentage of your practice revenues are derived from each of the following payers? (Note: Responses may not add up to 100 percent. If you cannot estimate, you may leave this question blank, but please complete the survey.)

7.Which of the following best describes your primary form of medical practice?
8.How many physicians are in your group or partnership? (Please report a number. If you are unsure, you may leave it blank.)
9.Please add any comments you may have regarding Medicare fee cuts:
10.May we share your comments with the public?