March 30, 2012

In yet another example of the failed policies of the Obama Administration including the president’s taking more than $500 billion from Medicare to fund his government takeover of healthcare, a recent article tells the story of a Wisconsin clinic forced to decline new Medicare patients because of basic economics.

Wildwood Clinic co-founder Dr. Paul Wertsch explains his practice can no longer afford to provide care to additional Medicare beneficiaries.

“Medicare pays only a quarter to a third of every dollar the clinic charges, Wertsch says, often half of what private insurance carriers pay.  When you figure that overhead for the clinic…ads up to around 80 cents on the dollar, accepting Medicare is a losing proposition, he says.  ‘I love taking care of Medicare patients…but every time we treat them we have to dig into our wallets.  What kind of business model is that?’”

The Wisconsin Medical Society is afraid Wildwood Clinic is just the beginning of a trend.  Apparently, Wildwood is the first clinic in Madison and maybe even all of Wisconsin “to bail out of accepting new Medicare patients,” says Medical Society VP Dr. Tim Bartholow.  “‘This is the canary in the mine,’” he warns.

Bartholow explains:  “‘Our nation can’t continue on the course we’re on…Frankly, this is a dangerous time.  We don’t want to panic people but my concern is, are our mothers and fathers and grandmothers and grandfathers going to be able to find a doctor to care for them?’”

“‘It’s not that we are greedy doctors’ Wertsch says.  ‘But all the uncertainty [around Medicare reimbursement cuts] is demoralizing.  If we fold, what happens to our other patients?’”

Indeed, physicians around the country are concerned about keeping open their doors to new Medicare patients.  The article refers to a March 2012 MedPAC report (previewed in an earlier Medicare on Main Street) which reveals a “worrisome” trend.  “Fourteen percent of participating primary care doctors surveyed refused to accept new Medicare patients, compared to 4 percent of physicians in other specialties.  At the same time, the percentage of beneficiaries who report a ‘big’ problem finding a doctor doubled,” according to the article. 

Of note, the MedPAC report pays special attention to the Commission’s “serious concern” about beneficiary access to primary care in Medicare especially in light of pending fee reductions in current law.  To wit, “the Commission finds it crucial to protect primary care from fee reductions, considering that the most recent data show that access risks are concentrated in primary care…This issue is a serious concern not only to the beneficiaries who are personally affected but also—on a larger scale—for the functioning of our health care delivery system.”

Wildwood Clinic’s no longer accepting new Medicare patients may be a new phenomenon in Wisconsin, but examples of this “bailing out” of Medicare, in one form or another, are growing in number throughout the country.  Unlike the president, House Republicans take on these challenges with a budget that ensures Medicare can fulfill the promise of seniors’ health security for generations to come.  Premium support, competitive bidding, and more help for those with lower incomes and greater health needs will ensure guaranteed affordability and improved access for America’s future seniors.

 

Key Take-Aways Losing money on a per patient basis is among the reasons doctors are refusing to accept new Medicare patients. The president cut more than $500 billion dollars from Medicare to pay for new entitlements we cannot afford. The House-approved budget saves Medicare for current and future generations with no disruptions for those in or near retirement.