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More physicians refusing to take new Medicare patients

Posted August 23, 2010
Updated August 24, 2010

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— The national health care reform law, which was designed to provide insurance coverage and access to physicians to more Americans, has no provision to help a group already having difficulty finding doctors to treat them – senior citizens.

According to a report from Cigna Government Services, which processes Medicare claims in North Carolina and 17 other states, more than 80 physicians in North Carolina have opted out of Medicare in the past year. That's in addition to the 100 physicians statewide who stopped seeing Medicare patients in 2008, the report states.

Even more practices have stopped accepting new Medicare patients. Family Medical Associates of Raleigh, for example, decided three years ago to accept Medicare payments only from existing patients.

"The payment from Medicare for our services is less than it costs us to provide those services," said Dr. Conrad Flick, a partner in Family Medical Associates and a board member of the American Academy of Family Physicians.

The gap has grown every year, he said, as salaries and overhead costs have increased while the reimbursement rate under Medicare has remained relatively flat.

The decision to turn away patients on Medicare wasn't an easy one, Flick said, but it was the only option he and his partners had if they wanted to remain in business.

"Our job is to take care of patients, which is what we love, but if we can't run our business, we can't take care of any patients," he said, noting they continue to turn elderly patients away almost daily.

Shirley Roth, a 74-year-old Creedmoor resident, said she spent several months hunting for a new doctor after becoming disenchanted with the staff at her former physician's office.

"They wouldn't take me. They said they were full because I was on Medicare," said Roth, who works as the bookkeeper for her son's Raleigh business. "You get depressed. You wonder, where are you going to go for good care?"

Physician office, doctor generic More physicians refusing to take new Medicare patients

Flick said he's especially worried about rural areas, where physicians are few and far between and tend to have large percentages of Medicare patients. If those practices close or the doctors opt out of the Medicare program, senior citizens in those areas would have to travel long distances to get health care.

A battle brewing in Washington, D.C., could drive even more physicians from the Medicare program or force some practices to close.

A 23 percent cut to reimbursement rates is scheduled to take effect Dec. 1, followed by another 6.5 percent cut in January. The cuts are mandated by a law that links reimbursements to growth in the gross domestic product.

Lower cuts were supposed to take effect in June, but Congress approved a so-called "doc fix" to delay them for six months. Some members of the House and Senate want to increase Medicare payments to keep physicians and hospitals in the system, but a vote isn't likely before the November elections because the move could add $22 billion to the federal deficit.

President Barack Obama signed the "doc fix," which increased reimbursements by 2.2 percent, but his administration recently touted savings in the Medicare system, such as lower reimbursement rates, for putting the system on better financial footing.

"It's a political hot potato," Flick said. "They don't want to be the one who makes the cut or makes the change because it's not very good politically for them in an election year."

Roth, who eventually found a new doctor, said senior citizens need to lobby Congress for Medicare upgrades.

"We need to all get out there and say, 'Hey, we need help. How do we make this work? What are representatives and senators doing to help us?'" she said.

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  • leahdudowicz Aug 25, 2010

    The American Medical Association is very concerned about seniors’ access to physicians under Medicare. By January 1, the Medicare physician payment cut will rise to a whopping 30 percent and will put seniors’ health in great jeopardy. Already, about one in four Medicare patients looking for a new primary care physician are having trouble finding one. About one in five physicians are already limiting the number of Medicare patients they treat because of the threat of future payment cuts and the already low the Medicare payment rates. Physicians are struggling to keep their doors open to all Medicare patients when payments are so far below the cost of providing care. Congress must stop the cut and fix the broken Medicare physician payment system to protect and preserve access to health care for today’s seniors and the baby boomers who begin aging into Medicare next year.

    -American Medical Association

  • awomnsptofview Aug 24, 2010

    " The govt. shouldn't be providing phones. You and your family should have pitched in for your brothers phone...you know...out of the kindness of your hearts.
    Winston"

    Like I said earlier... You dont have a CLUE what you are talking about,,,not even a clue..so, using your quote, OUT OF THE KINDNESS OF YOUR HEART, please shut up !!!

  • iamsiam1096 Aug 23, 2010

    Sad thing is they were warned this would be a fall out from the abysmal plan they rushed together. Our medical system has issues, but it did not need to be replaced with this junk.
    I don't blame the doctors, they have a right to make a living.

    It is sad our leaders were campaigning and assuring the elderly would be ok...yeah right, and they wonder why we don't trust or believe what comes out of DC...
    They need to gut congress and start over with folks with common sense and who have had to work in the real world. But as long as they promise freebies to all those voters who don't read or understand how government works..the regular working folks are going to continue to be the ones getting their pockets picked.

  • tommys5 Aug 23, 2010

    "like reducing their income" butterpie

    When did you request your last reduction in pay or refused a raise?

  • tamiya_stars Aug 23, 2010

    Good for them. I have always thought the future of healthcare would be more and more health care providers refusing Medicare, and actually all insurance.... and then charging their patients a reasonable fee for their services that the patient pays for on the spot. No government involved, no insurance hands in the pot, no paperwork, just do business the old fashioned way plain and simple.

  • Winston Aug 23, 2010

    "Be careful criticizing something you know NOTHING about." awomnsptofview

    The govt. shouldn't be providing phones. You and your family should have pitched in for your brothers phone...you know...out of the kindness of your hearts.

  • bill1nc Aug 23, 2010

    thanks Kay Hagans

  • raleighaligheri Aug 23, 2010

    "Interesting that some members of one of the highest paid professions refuse to look at certain cost cutting measures, like reducing their income, and instead opt to only take in patients that can insure their high income."

    Butterpie, go to twelve years of college and serve a residency. Get yourself some student debt into the high six figures at two or three different schools. Buy malpractice insurance that costs five figures per month so you can go into business in the first place.

    At that point, you'll be in a position to tell a doctor that they make too much money.

  • NCPictures Aug 23, 2010

    "Medicare rates are more than reasonable. Most doctors and all insurance companies should be treated like criminals for what they charge in relationship to the service provided."
    claytontarheel

    Yup, most liberals would make profit a CRIME if they could Most doctors I have worked with are more than happy to accept patients that dont have insurance. As a matter of fact they will lower the rate for those people. (I have done it). Most people have no idea what it costs to run a practice, or the insurance they need to have. Do you think doctors should work for FREE?

    Too many people just expect everything to be given to the, It is time that you GROW UP and be responsible for YOURSELF. Life has a cost. and when you have things done or buy something you have to pay for it. If you cant afford it then give up the cable TV or your fancy phone, or your fancy car. It is called PRIORITIES.

  • awomnsptofview Aug 23, 2010

    As far as the free cell phone, my brother had cancer and FINALLY got Medicaid and received one of these free phones. It was for 200 minutes a month in case of emergency for medical purposes. He DIED 3 weeks ago VERY unexpectedly at 52 years old from complications we dont know. His tumor markers were so low he was almost in remission. Still he is gone. Did I mention that up until 3 years ago, he always made in the $50k range. Be careful criticizing something you know NOTHING about.

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