The effects of Medicare and Medicaid reimbursement on the financial viability of clinics and physician practices in medically under-served areas of Wisconsin.

A survey of 21 physicians and clinic managers located in Health Professional Shortage Areas (HPSAs) and other under-served areas in Wisconsin found that to combat increasing costs, Medicare and Medicaid discounts, charity care demands and physician recruitment difficulty, several practices rely on outside sources of funding to remain financially viable. Also, the financial viability of physician practices in under-served areas of Wisconsin is threatened more by the reimbursement rates of Medicaid and Medicare than by the provision of charity care. Though few are limiting the number of Medicare and uninsured patients they will treat, many practices have begun implementing cost-containment measures, including more strict collection policies. There are also indications of restricted access for Medicaid patients at some sites.