Medicare definitely pays less than other payers, there is no debating that. However, the money they do pay gets paid faster and with less difficulty than almost any other payer. The do require pre-authorization on numerous procedures, medications, treatments, etc. but not any more than most other payers these days and their pre-auth process works better and is faster than pretty much any of the others. I totally understand the reduced reimbursement and would be concerned about running a clinic on those rates exclusively but I would love it if most other payers would learn from medicare with regards to operational efficiency.