Medicare really a gray area – Number of local doctors who accept such patients difficult to ascertain

By Morgan Chilson
http://cjonline.com

Getting a solid grasp on what will happen to Topeka’s Medicare patients should a 10.6 percent cut of physician reimbursements come to fruition is challenging.

While Congress has passed legislation that would halt the cuts, President Bush has vowed to veto it.

Stormont-Vail HealthCare primary care physicians already announced they would no longer take new Medicare patients if the proposed cuts go into effect. Although St. Francis Health Center and some independent physicians have said they would continue to accept Medicare patients, most have said they limit their practices to a certain percent of Medicare patients. But it is difficult to tell when those slots would fill up.

In a computerized world typically exploding with statistics and numbers, there isn’t really a way to tell how many physicians accept Medicare patients at any given time, said Julie Brookhart, spokeswoman for the Kansas City office of Centers for Medicare and Medicaid Services.

That is because physicians tend to opt in and out of Medicare, she said. That decision usually is based on their personal decisions to carry a certain percent of Medicare patients in their practices. The numbers change constantly.

At St. Francis, most physicians carry between 15 percent and 20 percent of their practice as Medicare patients, said Michael Schrader, president.

“It quite literally depends on the physician’s practice on the day that you called them,” he said.

In fact, calls to the St. Francis Jewell Street clinic asking about an appointment date for a new Medicare patient solicited the following response from the receptionist: “We take one new Medicare patient a month per doctor right now. We’re booking in December or January.”

Schrader said that practice carries an 18.4 percent Medicare load. Other practices, such as the clinics at Mission Woods, River Hill and Hunter’s Ridge, are open to new Medicare patients and booking appointments within four to six weeks, he said.

St. Francis probably averages 20 new Medicare patients a month, said Kim Gronninger, hospital spokeswoman.

One of the difficulties in determining where Topeka stands on Medicare treatment is that most physicians will continue seeing a patient who has a history with their practices when they turn 65 and go on Medicare.

Nancy Burkhardt, spokeswoman for Stormont-Vail, said the change by Cotton-O’Neil physicians primarily would affect new people moving to the area or those patients who lose their doctor for some reason and need to go to a new doctor.

Burkhardt said she didn’t have access to the average number of new Medicare patients Stormont-Vail physicians see in a month. But should the practices reopen if the cuts don’t go through, 18 doctors out of 72 are taking new Medicare patients.

While it is a concern if the Topeka community were to lose those 18 doctors for new Medicare patients, people who work with the aging population aren’t seeing an overwhelming concern or hearing that patients can’t get appointments.

Marian Clinic, a St. Francis-supported clinic offering medical care for people without health insurance, helps its patients move into the Medicare system. Once a patient can take Medicare, which is considered an insurance, they can’t continue to get care at the Marian Clinic, said Charlotte Rinsley, social worker.

Right now, Rinsley has 81 patients since the first of the year who are ready to begin Medicare and need new doctors. She says those patients typically are absorbed into St. Francis physician practices. She said the number of patients leaving the Marian Clinic to use Medicare varies significantly from year to year.

“People are very concerned about who will take me as a patient, will I get a doctor who really is skilled and who can handle my chronic needs,” she said of patient concerns expressed to her.

There is an option for individuals who can’t get a doctor’s appointment quickly, said Lesli Clark, public information officer for the Shawnee County Health Agency. That agency sees Medicare patients, and the waiting time is usually three to four weeks for an appointment.

Jerry Slaughter, executive director of the Kansas Medical Society, said that up until now, most Medicare patients — almost 90 percent — in the state have been able to find a Medicare physician. But he is concerned that may not continue if the cuts go through.

“Physician fees have been basically frozen in Medicare for several years,” he said. “It’s not just this one cut. Everything has gone up — rent, heat, lights, buying medical equipment. It’s this one top of Medicare falling further and further behind. There are upwards of an additional 30 percent of cuts that are scheduled to take place in Medicare over the next several years.”

Should the 10.6 percent cuts on the table go through, St. Francis’ Gronninger said the physician network would lose $500,000 off the top, and Stormont-Vail’s Burkhardt said their physicians would lose $3 million.

Morgan Chilson is a freelance writer living in Shawnee County.

She may be reached

at morgan@exactlywrite.net.

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