Favorite

Medicare's senior moment 

Pay, hassles have doctors turning away older patients.

A woman we'll call Ellen (not her real name) told a reporter lately about her trouble finding a gynecologist in Little Rock who would accept Medicare. Her own doctor, whom she'd seen for eight or nine years, had "dumped" her, saying she was no longer accepting Medicare reimbursement.

Ellen said it reminded her of the situation in the 1960s, when the Medicare law was first passed: It was common to see "We do not accept Medicare" signs in doctors' offices. Eventually, they did accept — but 50 years later, participation is declining.

Ellen was looking for a female gynecologist, which narrowed her field. There are gynecologists who accept Medicare, but many don't. A quick (and unscientific) survey of private practice ob/gyns physicians in the Little Rock phonebook found eight doctors who do not participate in the single-payer government system and 15 who did, though one of them was not accepting new gynecological patients.

Dr. Karen Kozlowski, an ob/gyn winner in a previous Best Doctors survey, recently dropped her Medicare patients. She did so "because it's a pain in the ass dealing with the government," she explained.

"You work your tail off, jump through all kinds of hoops to satisfy requirements that may or may not have anything to do with good patient care. And to be honest, reimbursement sucks," Kozlowski said. She said she is providing her former patients information on Medicare providers, information that is also online at medicare.gov/find-a-doctor.

Kozlowski said anticipated future hassles — including the requirement that she go to electronic medical records — was another reason she dropped Medicare.

Kozlowski's specialty is not the only one losing Medicare providers. The loss is across the board, David Wroten, director of the state Medical Society said. "The formula that Medicare uses to determine what it's going to pay physicians is a mess," Wroten said, one that Congress has not had the "intestinal fortitude" to fix.

Uncertainty over reimbursement — and questions about what the future holds — "drives physicians up the wall," said Dr. Joe Thompson, director of the Arkansas Center for Health Improvement. Since 1997, the balanced budget amendment has required that payments to doctors be ratcheted down every year — but that reduction has never happened. "Each and every year, Congress has come along and put a Band-Aid [on the amendment] and said they were not going to implement" the reduction, Thompson said.

This year, the Band-Aid came late twice, leaving doctors without Medicare reimbursement for several weeks. The program's administration, Dr. Brad Baltz said, "is an absolute disaster."

Baltz, one of the top hematologist/oncologists named in this year's Times survey, said he went without reimbursement for six weeks this year because of congressional and Medicare system delays. His cost of chemotherapy drugs runs $250,000 a week. To pay the bills, he had to take out a loan and increase patient load. Sixty percent of his patients are seniors on Medicare.

The country's health insurance system overall, Baltz said, "is beyond fixable," a problem that will "take some really smart people who see both sides of the road" to alleviate. He said he'd "absolutely" support a single-payer system, eliminating insurance companies and letting the government administer health care. The benefit: One payer with one set of rules and policies for allowed procedures, access to care and payment. "We're working for the government anyway," Baltz said. But, he noted, the American insurance industry will never let it happen.

The Medical Society's Wroten said Congress' shorter fixes — delaying cuts for a few months rather than a year or 18 months — have kept doctors guessing. A cut of 21 percent in Medicare reimbursement could go into effect in November if Congress decides to apply no more Band-Aids.

Wroten said his office is hearing weekly from patients who can't find a Medicare provider and from physicians whose parents or other family members can't find a provider, especially in Little Rock. The AMS hasn't conducted a survey to get a number on how many doctors are no longer accepting Medicare reimbursement, he said, because "it's so obvious," but a survey by the American Academy of Family Physicians cited in USA Today found that 13 percent of its respondents in 2009 did not participate in the Medicare program, an increase from 8 percent in 2008 and 6 percent in 2004.

Arkansas physicians get hammered another way, Wroten said: Medicare reimbursement is based on regional factors, and Arkansas's is the lowest in the nation. "It hurts us on recruitment, and it hurts us on physicians willing to treat Medicare patients."

In its survey, the Times asked doctors who are taking new patients if they accept Medicare reimbursement. A huge majority indicated they are — 153 doctors, 84 percent of those who chose to respond to the question.

But 40 doctors (78 percent of those who chose to respond the question) who indicated they previously accepted Medicare patients no longer do.

Thirty-seven non-pediatricians indicating they do not accept Medicare included family practice doctors, internists, hematologists/oncologists, infectious disease doctors, neurologists, psychiatrists, rheumatologists, plastic surgeons, a urologist and, surprisingly, four geriatricians (perhaps they only see Medicaid patients). Ten surgeons — heart, cancer, otolaryngology, thoracic, neurological and OB/gyn — indicated they do not accept Medicare patients.

Favorite

From the ArkTimes store

Comments

Showing 1-1 of 1

Add a comment

 
Subscribe to this thread:
Showing 1-1 of 1

Add a comment

More by Leslie Newell Peacock

  • Third Friday in Argenta: Artwalking to see Southern landscapes and more

    Works by some of Arkansas's most distinguished artists, including the late Al Allen and Carroll Cloar, along with famed regionalist Thomas Hart Benton make up part of the offerings in "Southern Landscapes," a new exhibition at Greg Thompson Fine Art (429 Main St.) opening with the monthly Third Friday Argenta ArtWalk tonight.
    • Aug 18, 2017
  • 'Sign of the Times': Political posters at CHARTS

    Hendrix College's Dr. Jay Barth will give a talk and sax player Dr. Barry McVinney and pianist Mark Binns will provide the music at tonight's opening of "The Sign of the Times: The Great American Political Poster" in the Windgate Gallery at UA Pulaski Tech's CHARTS (The Center for Humanities and Arts). The event runs from 6 p.m. to 8 p.m.
    • Aug 17, 2017
  • GiGi's opens with soul food and 'old school R and B vibe'

    GiGi’s Soul Cafe and Lounge at 10840 Maumelle Blvd., where the Nashville Rockin Grill was located, opened July 28 and co-owner Darrell Wyrick the restaurant is “bringing back the spirit of some of the places that have gone, like Porter’s and The Afterthought” with its soul food and “old school R and B vibe.”
    • Aug 16, 2017
  • More »

Readers also liked…

  • The ballad of Fred and Yoko

    How one of the world's foremost Beatles collectors died homeless on the streets of Little Rock.
    • Mar 31, 2016
  • 2016 Best of Arkansas editors' picks

    A few of our favorite things.
    • Jul 28, 2016
  • Visionary Arkansans 2016

    They make an impact.
    • Sep 15, 2016

Most Shared

  • Take yourself there: Mavis Staples coming to LR for Central High performance

    Gospel and R&B singer and civil rights activist Mavis Staples, who has been inspiring fans with gospel-inflected freedom songs like "I'll Take You There" and "March Up Freedom's Highway" and the poignant "Oh What a Feeling" will come to Little Rock for the commemoration of the 60th anniversary of the desegregation of Central High.
  • Klan's president

    Everything that Donald Trump does — make that everything that he says — is calculated to thrill his lustiest disciples. But he is discovering that what was brilliant for a politician is a miscalculation for a president, because it deepens the chasm between him and most Americans.
  • On Charlottesville

    Watching the Charlottesville spectacle from halfway across the country, I confess that my first instinct was to raillery. Vanilla ISIS, somebody called this mob of would-be Nazis. A parade of love-deprived nerds marching bravely out of their parents' basements carrying tiki torches from Home Depot.

Latest in Cover Stories

Event Calendar

« »

August

S M T W T F S
  1 2 3 4 5
6 7 8 9 10 11 12
13 14 15 16 17 18 19
20 21 22 23 24 25 26
27 28 29 30 31  

Most Viewed

Most Recent Comments

 

© 2017 Arkansas Times | 201 East Markham, Suite 200, Little Rock, AR 72201
Powered by Foundation