Ever-fewer doctors accepting Medicare

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Ever-fewer doctors accepting Medicare

By Marsha Austin

Denver Post, May 21, 2003

Elderly Medicare patients in Colorado are having an increasingly difficult time getting in to see a doctor.

The number of primary care physicians accepting new Medicare patients dropped substantially for the third year, according to the Colorado Association of Family Medicine Residencies.

About 34 percent of Colorado family physicians are accepting new members of Medicare, the federal government's health program for people 65 and older. That's down from 52 percent in 2001, when physicians statewide were first surveyed.

"It's alarming it's gone down this much," said Kathy Lindquist-Kliessler, executive director of the Denver Medical Society.

About 46 percent of the 1,646 physicians surveyed didn't respond. Those doctors may not have wanted to admit they are turning seniors away, said Kabira Hatland, a spokeswoman for the group.

Doctors cite shrinking government reimbursement as the top reason for closing their practices to seniors.

Congress cut physician payments 5.4 percent in 2002 and was scheduled to drop reimbursement another 4.4 percent this year. After physicians nationwide threatened to stop seeing Medicare patients altogether, lawmakers approved a 1.6 percent average pay increase.

But Colorado physicians say Medicare still doesn't pay enough to cover the cost of caring for elderly patients, who often have the most complex health problems.

Dr. James Regan, a Denver doctor known for his unwillingness to turn away poor or elderly patients, is leaving private practice next month because he was working past 10 p.m. nightly.

"The problem is the reimbursement is so slim you have to see as many patients as you can," Regan said. "I would never say no and on any given day I'd have 100 percent Medicare patients."

Regan is taking a job at the University of Denver's student health service. He's having a hard time finding a physician to take over his practice.

"All Medicare means is long hours and making considerably less money," he said.

Doctors fear further cuts to reimbursement next year.

After Congress prevented pay cuts to physicians in 2003, "everybody breathed a sigh of relief," Lindquist-Kliessler said. "But within a matter of weeks they came out with the news that it could drop another 5.5 percent next year and continue to drop every year after that."

The Association of Family Medicine Residencies surveyed the doctors as Congress was debating physician payments. The organization represents Colorado's 10 training programs for family physicians and wanted to gauge the state's need for new primary-care doctors, said Dr. Martin Kiernan, director of Saint Joseph Hospital's residency program.

In the past three years, applications to Kiernan's residency program have dropped 50 percent.

Medicare patients, especially those who are new to Colorado or who must switch doctors because they've changed health plans, already are struggling to find a doctor, said Hal Prink, a patient advocate at Lutheran Medical Center.

Prink has helped countless seniors get doctor's appointments in the past few years, but said it's getting tougher.

When seniors can't get in to see the doctor, they typically end up in the hospital emergency room or without needed care, he said. "I think we've got a health-care crisis on our hands."