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WASHINGTON — Medicare reimbursements to doctors are set to drop by nearly 5 percent next year, an amount that physicians say could make it harder for elderly patients to see a doctor.

Mark McClellan, administrator for the Centers for Medicare and Medicaid Services, told reporters Monday that the agency would soon issue new regulations updating reimbursement rates for physicians. He did not provide an exact amount the rates would change in 2007, but trustees for the Medicare program projected in May that the cut would be 4.7 percent.

The reimbursement rates are established by formula, which sets annual and cumulative spending targets for physician reimbursements. When spending increases exceed economic growth, payments to doctors are supposed to be cut.

McClellan attributed proposed payment reductions to a "vicious cycle" in health care. Doctors provide more and more services per patient, which drives up Medicare spending faster than the overall economy.

However, Congress in the past has headed off similar reductions called for by federal regulation, and it's expected to step in again this year once lawmakers return from their August recess.

Already, 80 senators wrote their respective leaders in that chamber last month to say they believe the Senate should increase the reimbursement rates for doctors before Congress adjourns in October.

McClellan said he was optimistic that the federal government could also make some structural changes as soon as this year in the way doctors are reimbursed. Those changes would focus more on paying doctors when they provide services proven to improve patient outcomes rather than just reimbursing doctors for more care.

He said he is seeing more leadership from physician groups this year when it comes to providing guidance on how the government could undertake such a transformation.