A new state task force set out yesterday to determine if there is a problem with physician reimbursement and, if so whether it is affecting the availability of doctors in the state.
Its findings could spotlight what so far has been primarily a simmering issue between doctors and insurers.
For years, the state's doctors have complained that they're being underpaid by insurance companies. The Maryland Health Care Commission estimated that Maryland is in the bottom quarter of states nationally in how much doctors are paid for each unit of service.
But the national comparisons are murky, and the doctors concede that much of their information is anecdotal.
"The issues of access and reimbursement are closely linked," said state Health Secretary John M. Colmers, chairman of the task force, during the initial meeting. If reimbursement is too low, whether generally or in specific specialties or regions of the state, people might have trouble finding a doctor.
On the other hand, task force member David D. Wolf, interim chief executive officer of CareFirst BlueCross Blue Shield, reminded his colleagues that high reimbursement drives up health insurance premiums, meaning fewer can afford coverage. "We clearly believe the affordability issue is creating an access issue," he said.
Ordered up by the legislature in this year's session, the task force is to make a preliminary report by the end of the year and a final report by July 1. Members include legislators, doctors and the state's insurance commissioner.
So far, the state isn't sure how many doctors are in active practice. More than 22,000 physicians are licensed, but some of those are retired, and others spend all or most of their time teaching, in research or in administration.
MedChi, the state medical society, and the Maryland Hospital Association are jointly conducting a study of how many doctors are actually treating patients, broken down by specialty and region.
The study also will attempt to forecast physician work force needs through 2015. Calvin Pierson, president of the hospital association, said the results should be reported to the task force within two months or so.
"There's a lot of anecdotal evidence and concerns on the part of physicians over having two dominant players" in the insurance industry, CareFirst and UnitedHealthcare, giving them too much power to set physician rates, said Dr. Martin Wasserman, executive director of MedChi. He said he hoped the commission would "see if Maryland physicians are being injured by the situation."
"My hope and expectation," Wolf said after the initial meeting, "is that we'll get a clearer understanding of what the facts are underlying the issues."