The interesting case will be with Medicare where the fee schedules are getting worse but the volumes are getting higher. Turn away Medicare patients and your volumes will be damaged. Federal government is proposing to make it more difficult for providers to stay out of Medicare as a new rule would make providers have to choose whether or not to contract with medicare definitively. Up until now there was the option to decide on a case by case basis. Obama knew doctors would try to flee the program liek so many do with medicaid as the rates got worse.

There is a long standing law that keeps getting "patched" that would decrease the fee schedule for doctors under Medicare tremendously (+20%).