Some Doctors Drop Patients On Medicare

Jan. 12--Janice Beaty is searching for a new doctor.

A few weeks ago, her gynecologist's office -- one she has visited for about five years -- called to cancel an appointment because her Medicare plan doesn't pay enough.

Beaty, 71, of Columbus, was surprised by the call but said she understood the financial concerns. That's when she started to shop around.

"I called a bunch of gynecology groups, and they aren't taking new Medicare patients," the North Side resident said. "This seems to be a trend."</p>

Medicare payments to physicians will be cut by 21 percent on March 1 unless Congress delays the action. This is the ninth year Medicare has proposed payment cuts.

Under the Medicare program, the federal government paid doctors $60.8 billion in 2008.

So far, Congress has enacted legislation at the last minute each year to freeze payments, fearing that physicians will stop treating Medicare patients.

There are about 45 million Medicare beneficiaries, including 1.5 million in Ohio. With baby boomers aging, the number is expected to explode in coming years.

Jeff Smith, director of government relations at the Ohio State Medical Association, said Medicare payments have been stagnant since 2001 while the cost to practice medicine has increased.

He said doctors aren't dropping Medicare patients in droves, but it's a growing trend.

"It's the instability of the Medicare program that causes them great concern and not being able to budget in a way to make sure your practice is sustainable," Smith said.

Congress created a formula that ties physician payments to the nation's economy. When the economy is good, payments can rise. When it's bad, payments can be frozen or cut.

Neither of the two health-care overhaul bills passed in Congress fixes the doctor payment formula, but there's a separate House bill that would, Smith said.

Meghan Dubyak, spokeswoman for U.S. Sen. Sherrod Brown, an Ohio Democrat who sits on the Senate health committee, said the plan is to change the way doctors are paid by Medicare this year.

U.S. Rep. Pat Tiberi said Beatty's story is becoming too common.

"This is a problem that existed before the health-care debate," said the Genoa Township Republican. "Fewer doctors are participating in the system."

He said the health-reform bills add people to the public rolls without fixing the problems with Medicare and Medicaid, a program that helps the poor.

"We're expanding a broken system by 31 million more people and we're not fixing the problems," Tiberi said. "There will be fewer physicians with more customers, and at the same time physicians taking Medicare are going to be seeing more cuts. It's a train wreck."

The Mayo Clinic recently announced that it will stop accepting Medicare payments at its primary-care facility in Glendale, Ariz., because the government program doesn't cover costs. Patients will have to pay cash.

Smith said Medicare patients and those approaching age 65 should push federal lawmakers to solve this problem so there will be enough doctors.

In the meantime, Beatty is hopeful she'll find a new gynecologist.

"Insurance is no good if you can't use it," she said.

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