Finding doctors who take new Medicare patients proves a puzzle

July 30--For some Frederick County patients on Medicare, finding a doctor has become a challenge.

About half of the county's 103 health care providers at family medicine practices take new Medicare patients, according to Dr. Randy Culpepper, deputy health officer at the Frederick County Health Department.

The county health department and Frederick Memorial Hospital keep lists of local doctors who take new Medicare patients, but those lists aren't public.

Medicare is a federal health insurance program for people age 65 and older, as well as patients with disabilities, end stage renal disease or Lou Gehrig's disease.

Vicki Quist, a Frederick resident, had trouble finding one of those 50 doctors.

Quist received nearly a dozen doctors' names during her search for one who would take her.

Her husband saw a cardiologist, who recommended two general practitioners, Quist said. She called them, but they weren't taking new Medicare patients.

Quist's dermatologist gave her two doctors' names, but they weren't taking new Medicare patients, either.

She called the dermatologist's office back, and a staff member gave her three more doctors' names. Quist then saw a second dermatologist, who recommended a doctor within walking distance.

That doctor wasn't taking new Medicare patients. Her second dermatologist gave her three more names.

"One of those said they would take me," Quist said.

Quist now has a doctor, but the process took about three weeks.

Her neighbor, Sandy Daiger, was accepted as a Medicare patient at her existing doctor's office. She's concerned she might go through a similar process if she chooses to switch doctors.

"I don't feel like I have much choice in doctors at this point," Daiger said.

But according to Culpepper, the number of doctors in the county -- and doctors who accept Medicare patients -- has increased, though the proportion of doctors who take new Medicare patients has stayed the same.

In 2013, according to the health department, there were 45 family practice providers in the county, and 36 served Medicare patients. Of those, 19 did not take new Medicare patients.

"We're likely to see an increase in providers, at least in primary care," he said.

Dr. John Vitarello, a cardiologist who practices in Frederick, has raised alarms about the number of doctors who are choosing not to take new Medicare patients.

"Physicians are declining or basically removing themselves from the Medicare providership for a lot of reasons," Vitarello said.

Doctors were required to start recording clinical data for Medicare patients electronically by 2014. Vitarello said those federal electronic health record requirements reduce doctors' efficiency and the amount of time they can spend with patients.

"You need information technology services to make the record complete, and that means paying to keep the system working," Vitarello said.

Doctors are paid less to serve Medicare patients than patients who use private insurance, because the Medicare program has higher overheads.

Taking new Medicare patients can be a "burden" on doctors, Vitarello said.

All 16 cardiologists in Frederick County, including Vitarello, take new Medicare patients, according to Culpepper's data. About 70 percent of Vitarello's patients pay for their medical needs through Medicare.

"Frederick County is a large Medicare community," he said.

Dr. Lee Krantz, who practices family medicine in Frederick and Thurmont, accepts new Medicare patients.

Medicare patients make up about 30 to 33 percent of his practice -- a relatively high proportion for doctors in family medicine, he said.

A few years ago, about 25 percent of his patients were paid for by Medicare.

"There's too many patients and too few doctors," Krantz said.

According to the Centers for Medicare and Medicaid Services, about 27,101 Frederick County residents were enrolled in Medicare in 2011.

By the end of 2015, that number had risen to 31,515.

As of June, 32,661 county residents were enrolled in Medicare.

Carolyn True, director of the county Department of Aging, said the department receives a couple of calls each month from Medicare patients looking for doctors who will take them.

Those calls are generally referred to Frederick Memorial Hospital's staff, who can recommend a physician for the caller.

"It's certainly a needed and necessary service," True said.

Twice each year, the hospital staff updates a list of local doctors who take new Medicare patients.

The county health department has a similar list, with information drawn from a survey they administer to doctors.

But, the survey process takes time.

"As soon as we have a list of Medicare providers, it's already out of date," Culpepper said.

The Centers for Medicare and Medicaid Services has a searchable database of doctors who take or may take Medicare patients.

True doesn't recommend that local residents use the database, called "Physician Compare," because it may be outdated.

Because of Daiger's and Quist's concerns, the county health department discussed the possibility of making its list of Medicare doctors public.

Culpepper declined, saying the list is not part of department staff's responsibilities.

"It isn't what my staff are paid to do, so I'm reluctant to release that information," he said.

Frederick Memorial Hospital also declined to release its list.

"We can't market doctors that don't work for us," hospital spokeswoman Melissa Lambdin said.

However, Medicare patients can call the hospital to get recommendations for doctors.

Heather Kirby, assistant vice president of integrated care delivery at the hospital, said the staff received two or three calls daily from patients of all insurance types looking for providers.

"Typically, we're able to find them someone to connect with," Kirby said.

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