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onecent Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 07:29 AM
Original message
Doctors refusing to take "new" medicare patients?
This is worrying me. Our hospital here in Missouri is building on more and more doctors buildings..and that is good..however the word going around
is the newest building to be completed soon is wanting the doctors who inhabit the building (tall high rise) to refuse all NEW medicare patients.

I am 66 years old and VERY concerned about this of course.

Don't have that many particulars on this problem. Yesterday was my first day as a volunteer for the hospital as November and December are very difficult
months for me since I lost my husband 4 years ago.

The hospital is in Liberty, Missouri and fast growing. I am outraged at what I was hearing from the other volunteers, who, of course, are also over 65..or so.

Have I been missing the news????? This seems VERY SERIOUS to me and I don't hear or see anything being said about it.
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OneGrassRoot Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 07:31 AM
Response to Original message
1. I work with physicians in private practice who have refused Medicare patients....
for several years now. They simply don't take Medicare at all.

:(


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w8liftinglady Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 07:33 AM
Response to Original message
2. yes. Which results in MORE patients using the ER as their primary physician
I am studying to be a nurse practitioner for just this reason...
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Yo_Mama Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 07:48 AM
Response to Reply #2
5. Well, yes, but you'll find out when you go into practice
that you just can't afford to treat the patients properly if you have too many patients on government insurance.

The problem isn't most of the doctors - it is reimbursements that are too low.
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 01:38 PM
Response to Reply #5
13. 500 million dollars of Medicare cuts were part of the
Package of "The Affordable Health Insurance" scam that was the "reform" offered to us by "our" government.

The MediCare Program may survive, but for all real intents and purposes, it will be worthless.
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Yo_Mama Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 07:35 AM
Response to Original message
3. Medicare reimbursements are scheduled for a 29.5% cut Jan 1st
So yes, it is real. Also more cuts are scheduled later for ObamaCare.

If you do a good job with most elderly patients, you'll lose big money on them next year. Doctors can't afford too many of that type of patient. Doctors have been controlling the number of Medicaid patients in their practices for a long time, and now they will get much more vigilant about keeping Medicare patient counts down too.

They have to pay their bills, their staff and their malpractice insurance. My own doctor is very upset about it, but he is not taking new Medicare patients any more. He is 71, so he knows how awful it is, but on the other hand he has to pay the bills to keep the practice open, so he has no alternative. And he does do a lot of charity work.

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no_hypocrisy Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 07:45 AM
Response to Original message
4. My father was a cardiologist/internist and ca. 80% of his practice was Medicare
until he retired in the early Nineties. He could afford to have that many Medicare patients back then. And to his credit, a lot of his patients lived to their nineties with heart conditions and other ailments.
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alc Donating Member (649 posts) Send PM | Profile | Ignore Tue Oct-25-11 08:06 AM
Response to Original message
6. nothing new
Doctors around my parents haven't taken new patients for 3-4 years. My parents' friends have a 3-4 hour drive (each way) for checkups.

I have a friend (solo family practice) who has has only paid himself about 2 or 3 months each year for the last few years. Every medicare patient is a loss and he doesn't make enough off other patients to cover office costs, staff, and his own salary. He loves the job and doesn't want to join a group practice (which limit medicare patients and limit time with each patient) so he lives off his spouses income - he pays himself when they want a vacation or need car or house repair, and just enough to cover it, not the outrageous amount many people think all doctors make.

Don't expect it to improve. Health insurance reform has additional cuts and if they aren't implemented the reform will be attacked for going way over estimated costs. You can argue that the cuts are only for waste, fraud, and supplemental programs, but I don't see those as enough making up for $500 billion without hurting seniors. Even without reform, they've been needing "doc fix" every year to keep automatic payments from being cut.

Also, many big providers, like Mayo, are balking at the proposed regulations created for reform (reform left the details up to agencies to figure out how to get the savings). They've threatened to stop taking medicare at all of their facilities. I'm not sure if they'll be able to turn down policies bought through the exchanges, but if those policies reimburse at a loss, you can bet hospitals will try to refuse them.
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Yo_Mama Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 09:22 PM
Response to Reply #6
15. I figured my doctor would net around $7 an hour next year
That's why he's forced to limit Medicare patients - he's near to having to shut down the practice. The staff are all making more an hour than he is. But he also refuses to handle Medicare like some practices - if he takes a patient he's really going to treat them.

Mayo has long charged additional fees to Medicare patients. Now they may be bagging out altogether.

I figure it will end up that Medicare will still be decent insurance for well-off retirees - they'll be able to pay going rates upfront in cash and will get some of that reimbursed by Medicare directly to them. But retirees on a tight budget won't be able to afford much in the way of primary care - they'll end up going to clinics and the ER for their treatment.

It's not going to save us money overall. ObamaCare was fake health care reform. Our ineptness in handling our health care system is catching up to us.
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Swede Atlanta Donating Member (906 posts) Send PM | Profile | Ignore Tue Oct-25-11 08:14 AM
Response to Original message
7. Yes, this is true....
I have two friends that have been with their primary care physicians for 10+ years on employer-paid health insurance. One of them went on Medicare this year and her doctor told her she would have to find a new doctor. She has yet to find anyone who would take her for more than an acute case of bronchitis, no permanent relationship. My other friend who plans to go on Medicare next April has been told by his doctor that he would be put in a lottery for Medicare slots - i.e. he will only take one as another patient leaves his practice (i.e. dies). This has been going on for years, not just since the Health Care Reform bill was passed. There may be aspects of the HCR bill that exacerbates the situation.

With the baby boomers starting to retire this will become more and more problematic.....looks like medical tourism has a bright future.
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HockeyMom Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 08:57 AM
Response to Original message
8. A bit off topic but relevant
I work for a school district which privately insurers staff. When a employee becomes eligible for Medicare, they are then dropped from the employee plan. Keep working to keep your company insurance? Not here you can't, and I wonder if more companies won't be doing the same.
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 01:35 PM
Response to Reply #8
12. That sucks. n/t
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REACTIVATED IN CT Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Oct-26-11 05:47 AM
Response to Reply #12
16. It is also illegal, based on the facts presented.
Under TEFRA (Tax Equity and Fiscal Responsibility Act of 1982) employer groups of 20 or more cannot force employees over 65 to take Medicare. If this school district employs less than 20 people (not insures less than 20, but employs less than 20), it can do this, otherwise it can not. To the best of my knowledge, government entities are not exempt from TEFRA

They can't offer a Medigap policy as an employer option, either, to actively employed individuals. Active employees over 65 must have the exact same health insurance choices as those under 65.

http://www.empireblue.com/wps/portal/ehpemployer?content_path=employer/noapplication/f4/s6/t1/pw_ad089109.htm&rootLevel=3&label=Tax%20Equity%20and%20Fiscal%20Responsibility%20Act%20%28TEFRA%29



This was originally done to save Medicare costs - to shift them back to the employer plans until the workers actually retired.



(posted by someone with 20 plus years of Benefits Administration experience)
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Donnachaidh Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 12:51 PM
Response to Original message
9. this is NOTHING new. It might be escalating though
Of course this isn't going to be talked about -- especially now when Washington has decided it needs to vilify and them eviscerate the program. :shrug:
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whathehell Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 01:16 PM
Response to Original message
10. This sucks....What can we do about it?
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 01:33 PM
Response to Original message
11. This is indeed serious, but it is nothing new.
That is the dirty little secret behind so many of the official pronouncements about MediCare.

The President saw to it that his "Affordable Health Insurance" Scam Act that was passed in 2009 included some 500 billion dollars worth of cuts to the "waste" in the program. (Not million - billion!)

Now he is aboard the notion of making sure that there are no "exorbitant" pay outs to doctors.

Well, most doctors who have MediCare patients have been refusing to add new patients for over fifteen years. The paperwork that is involved in getting paid take up too much staff time. The rates of pay are very low.

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SheilaT Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-25-11 03:41 PM
Response to Original message
14. This has been going on since the very beginning
of Medicare. There are doctors out there (probably retired by now, I suppose) who would never accept Medicare patients. Others who limit how many of them they will take in their practice.

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