Thread: Mayo Clinic in W. Valley to stop taking Medicare patents

Mayo facility in W. Valley to stop taking Medicare payments

by Cecilia Chan -
Nov. 27, 2009 12:00 AM
The Arizona Republic

Low reimbursements have led one West Valley medical facility to stop taking certain Medicare patients, a pilot program that an Arizona health-care expert says may become a long-term trend in the industry.
For now, most Valley hospitals are still taking Medicare reimbursements.

The Mayo Clinic announced in October that its Arrowhead Family Medicine practice will stop taking Medicare payments for primary-care services. The policy goes into effect Jan. 1, affecting about 3,000 seniors. Five doctors have practices at the clinic.

"We tend to see more Medicare patients in that area," said Lyn Closway, Mayo spokeswoman. "This is a (two-year) pilot, and we will re-evaluate or reassess this after an appropriate period of time."

For Mayo Clinic, the cost of providing services to Medicare patients exceeded the total amount paid on behalf of Medicare patients by $840 million in 2008, according to the hospital.

"Government payers, without question, are the worst payers in health care," said John Rivers, president of the Arizona Hospital and Healthcare Association. "Medicare shortfalls in hospital payments represent nearly $1 billion in Arizona alone. And those costs ultimately get shifted onto the backs of privately insured individuals in the form of a hidden health-care tax."

Rivers said Medicare payments can't be kept below cost forever without extensively damaging hospitals' ability to serve their communities. Opting out of Medicare may be the only choice for many to balance their books.

"Mayo Clinic was the first health-care system to go in this direction, and I don't think they will be the last," Rivers said. "Everyone else is facing the same pressures as Mayo Clinic, and I won't be surprised to see more of this in the future."

Medicare patients at the Arrowhead practice have the option of staying with their primary-care doctor, but they will have to pay a hefty price to do so: an annual $250 administrative fee, plus appointment fees of $175 to $400 per visit.

"I have to find a new doctor now," said Shirley McDonald of Sun City West. "I had the best doctor I have found since leaving the Stanford area in California.

"It's hard finding a good doctor. Trying to find one who doesn't stand 3 feet away while looking down your throat, saying, 'Looks good to me.' "
Although health-care providers are seeing a growing gap between Medicare reimbursement and their actual costs for providing care, other Valley hospitals say they don't plan to curtail services.

"In some communities we serve, we have well over 50 percent of patients with Medicare," said Kathy Bollinger, Banner's Arizona West Region president. "Banner Health has no intention nor should the communities have any intentions of us not accepting Medicare."

Two of Banner Health's 22 hospitals nationwide are in the West Valley retirement communities of Sun City and Sun City West.

"It's absolutely a fact that Medicare reimbursements in most cases don't cover the cost of care," Bollinger said. "So, we need to identify ways to live in a tighter budget."

That means Banner Health has to find a better use of staff and more efficient delivery of care, she said.

Arrowhead Hospital in Glendale declined comment.

At John C. Lincoln Health Network's two hospitals in Arizona, Medicare patients won't see any cuts in their services, CEO Bruce Pearson said.
When cost outpaces reimbursements from Medicare and Medicaid, health insurance for the poor, the cost shifts to people with private insurance, he said.

"The cost shift is what happens at all hospitals, including John C. Lincoln," Pearson said. "What has happened over the last decade is as Medicare and Medicaid have been reduced, hospitals had to negotiate higher rates with insurance companies. So private insurance is going up at a more rapid rate."

That route, however, is unsustainable, as Baby Boomers retire and people lose their private insurance because of the recession, he said.
The first of the Baby Boom generation, estimated at more than 78 million, begins to turn 65 in 2011 and qualifies for the nation's largest insurance program for seniors.

The Medicare Board of Trustees in a report this year stated that the program would be bankrupted by 2017.

http://www.azcentral.com/community/glen ... e1127.html

My doctor has a sign in his waiting room which says if the Health Care Bill now in Congress passes he will no longer be able to take Medicare patients beause of the medicare cuts in the Health Bill.

So what will happens to our seniors?

In San Diego you haven't been able to find a doctor who will accept new Medicare patients for more than a year so I'm not sure this has anything to do with the Health Care Plan. Doctors just don't want to accept the small amount that Medicare and Medicaid pay.