Hospitals / Doctors now refusing to take Medicare

[Anthony]

I thought this was a little interesting. I guess Bill HR676 wouldn't work anyways.

Mayo Clinic in Arizona to Stop Treating Some Medicare Patients Share Business ExchangeTwitterFacebook| Email | Print | A A A
By David Olmos

Dec. 31 (Bloomberg) -- The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.

More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota.

Obama in June cited the nonprofit Rochester, Minnesota-based Mayo Clinic and the Cleveland Clinic in Ohio for offering “the highest quality care at costs well below the national norm.” Mayo’s move to drop Medicare patients may be copied by family doctors, some of whom have stopped accepting new patients from the program, said Lori Heim, president of the American Academy of Family Physicians, in a telephone interview yesterday.

“Many physicians have said, ‘I simply cannot afford to keep taking care of Medicare patients,’” said Heim, a family doctor who practices in Laurinburg, North Carolina. “If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.”


Here's the link.

http://www.bloomberg.com/apps/news?p...d=aHoYSI84VdL0

[csx4910]

I live here in Phoneix and have worked in the health care field for 23 years. Mayo actually dtopped accepting Medicare for one of their clinics 3 months ago but it is finally making national news. Sorry to any docs out there, but I dont feel sorry for getting a 20% cut. My business (durable medical equipment) been cut over 40% from Medicare over 5 years yet we account for a whopping total of 1.8% of Medicares total budget. Doctors and hospitals(a much larger part than doctors) combine for approx 80-90% of Medicares total budget. If they want to cut Medicare true costs, then the hospitals first and teh docs second need to be trimmed. last year they didnt cut the docs pay then docked us 10% to pay for it.

Maybe Medicare should stop paying for Viagra for people and try paying for more drugs that would keep people OUT of the hospital rather than [ay for thier triple bypass once they have a heart attack

[Excaliber]

Are we standing by for "Patient Dumping" accusations to hit the fan any day now?

[Joe Wicked]

Originally Posted by Excaliber

Are we standing by for "Patient Dumping" accusations to hit the fan any day now?

We should be. I fully expect that the Dems will stand up and "point out" that this is why the government needs a public option, and the Reps will stand up and "point out" that this is why the public option will not work. As far as I am concerned, if doctors are actually LOOSING money (as claimed) then they have the right to not see those patients unless they agree to pay cash or have other payment.

[Ron61]

Joe,

My doctor stopped taking any new Medicare patients about 3 years ago. He will still see the ones he had before then but they are dying or moving to other states so he doesn't have many left and he said he was really going to be happy to be out of that mess. He used to have one woman that had to come in once every two weeks for some kind of a shot that back then cost about $9. Medicare would only pay $1.07 on it. So Niki, his wife called them and they told her there was a more expensive version of that show which cost around $20 and for her to turn that in and they would pay $17 on it. Now this is straight from the head of the Medicare department for Northern Calif. And they cry about fraud.

Ron

[cdnus]

I know this sounds simplistic---But why can't the Hospitals/doc's just charge their patients a Top Up fee rather than drop them stone cold to fend for themselves????
Or does medicare not allow for this practise.

Just asking

Craig

[Excaliber]

It's likely the patients could not afford additional fee's what with the co-pay, insurance payment's and all that all ready. If your on Medicare generally I would have to assume your also retired and on a fixed income. If your on Medicaid, again generally speaking, your dirt poor.

We had a thread a little while ago about University of Chicago Medical Center (UCMC) "dumping patients" on Medicare. Well in my opinion they are not "dumping" they are "redirecting" patients to other clinics and hospitals in the area. Sometimes even providing transportation for the patients. Patients DO receive emergency medical care and are stabilized if required and then "urged" to seek followup treatment elsewhere.

The basic structure has worked out rather well for the other area clinics and hospitals. They get patients that can provide at least Medicare monies. For some of these facilities it has meant the difference between closing the doors and staying open. Arizona should consider this plan.

[Ron61]

Originally Posted by cdnus

I know this sounds simplistic---But why can't the Hospitals/doc's just charge their patients a Top Up fee rather than drop them stone cold to fend for themselves????
Or does medicare not allow for this practise.

Just asking

Craig

I am not sure about how other places do it, but I pay my doctors bills in cash and get a pretty good break on the charges. Saves them the work of submitting papers and then waiting to see what amount they may get. Plus all of the laws this state has added are adding to the cost. A good example was when I went in last year for blood work. Mary brought the two capsules and needle in to take my blood and they were sealed in plastic. They were on a tray about 10" from me and Ron stopped and asked her a question and she was never more than a foot from the tray. But because she had taken her eyes off the darn things for that second or so, she had to throw them in the waste bin still sealed in plastic and get another set. I asked Ron about it and he said it just wasn't worth taking a chance on having his license pulled if anyone happened to see she wasn't looking at them every second and told the medical board. Basically the same for my dentist. He can only use certain tools more than once, and once that law went into effect the manufacturers immediately tripled the price of those tools. Then he had to pay a ton of money for some kind of ultra sonic oven to clean other stuff with and keep a log which has to be sent in monthly.

Ron

[cdnus]

Ron,
Hoping you never do, but what if you require major surgery with hospital stay??
Who pays etc.? Medications, who pays?
What's your age? Retired?

Craig

[DAVID GAGNARD]

Doctors around here are starting to refuse any new Medicare patients, referring them to any other doctor that will have them and that list is getting smaller and smaller everyday...........

My daughter works in a local doctors office here. She does medical billing/transcribing/insurance claims.etc.,etc..........

She told me about one Medicare patient the doc sees on a regular basis, he gets a whopping $16.00 from Medicare for the office visit!!!!!!!!!!!!

No wonder why they are dropping patients and refusing any new ones!!!!!!!!!!!!!!!!

David

[Anthony]

Originally Posted by cdnus

I know this sounds simplistic---But why can't the Hospitals/doc's just charge their patients a Top Up fee rather than drop them stone cold to fend for themselves????
Or does medicare not allow for this practise.

Because that would then be fraud. Every medical service has a code associated with it, and each code is reimbursed by medicare for a set fee as determined by them. To "up-Charge" would be to bill for a higher reimbursement code that was not actually provided, and therefore be considered fraud. If you are audited by medicare, they go through your charts and billing to see if you have the proper documentation supporting your charges. If there are discrepenceies, favoring the doctor, they are considered fraud, and I think are subject to a $5000 fine for EACH OCCURANCE.

When a hospital or doctor signs up with Medicare, Medicaid, BWC, or any insurance company, what they are doing is agreeing to accept a set reimbursement fee set by the insurance provider such that the medical provider cannot bill the patient in excess of this. The only way to get around this is to "opt out", that is, terminate the agreement making the patient fully responsible, with the exception if the insurance provider provides "out-of-network" benefits, then the insurance will pay part of the bill. Medicare, Medicaid, BWC have no out of network benefits, as with some other insurance plans, and therefore the patient owes the full balance unless the medical provider grants a discount for cash pay.

[Anthony]

Originally Posted by Excaliber

We had a thread a little while ago about University of Chicago Medical Center (UCMC) "dumping patients" on Medicare. .

It was actually Medicaid, actually a big difference, about 25%, when they do pay.

Originally Posted by Excaliber

The basic structure has worked out rather well for the other area clinics and hospitals. They get patients that can provide at least Medicare monies. For some of these facilities it has meant the difference between closing the doors and staying open. Arizona should consider this plan.

Maybe you should give them a call and enlighten them.

[Excaliber]

No need to call them, I'll just pass it on to Barry when I give him my weekly update on the CC right wingers around here...

Medicaid (welfare) pays about 25% MORE than Medicare?

[Ron61]

Originally Posted by cdnus

Ron,
Hoping you never do, but what if you require major surgery with hospital stay??
Who pays etc.? Medications, who pays?
What's your age? Retired?

Craig

Craig,

I have coverage for major medical problems. I just don't use my coverage for other things. Plus I have it in my powers of attorney that if I am injured or otherwise in very bad shape they are to take no unusual means to revive me. I am 69 and have never used any taxpayer money for my medical needs.

Ron

[Wayne Maybury]

Keep well Ron.

Wayne

[Ron61]

Wayne,

Thanks for the wishes. I will be ok. Just have to deal with my problems as best I can. No doctor or medical procedure can cure my main problem and therefore I see no need to waste money on continual visits to the doctor or hospital. I am going in next week but that is for a cut on my arm.

Ron

[4RE KLR]

Doctors no longer accepting government funded health-care is just the tip of the iceberg. This is just the beginning folks.

My niece is also in health care and they have also stopped accepting any forms of government funded payment for health care.

You cannot blame the doctors for this. If you own your own business and you are loosing money on a specific income stream it is only prudent business to stop that effort.

Other wise you will go broke!

[Excaliber]

Other wise you will go broke!

Well I won't worry about the Doc's going broke, but it could mean the difference between buying a Ferrari and having to lower your standards to a mere Z06.

[4RE KLR]

LOL

I don't know any doc's with Ferrari's. But I am sure there are plenty. I guess it would depend on what type of medicine they practiced.

[Bobcat]

Ernie ... your comment about the doctors having to buy a mere ZO6 instead of a Ferrari is in my opinion , a common misconception about doctors ..... and I`m sure there a a bunch out there who do extremely well . But , there are just a many who make in the $60,000 to $100,000 range , and yes , I know this for a fact . It all depends on their specialty and how hard they are willing to work . I know one personally who makes $300k +/yr , but here`s the kicker . He is at the hospital at 5:30am , 6 days a week for rounds , goes to his office and sees 15+ patients with really nasty stuff ( full blown HIV , Hep. B , C etc and raging staph infections ) ... then goes home , eats supper and is in bed by 8:30 . This doesn`t count his time in med school and the debt he had when he got out . Are you saying he doesn`t deserve what he makes ?
BTW , he also is a volunteer pilot for Angel flights in his "spare time " on his own dime .
As I said , some do very well , but if a person is willing to work , have a specialty and know what you are doing , you will do well ... as you will in any other profession , but I`ve found a lot of people are more willing to complain than work . There is an old saying , the harder I work , the luckier I get !
No , I`m not in the health care field ( 2 daughters are ) ... and I didn`t stay at a Holiday Inn at all this year !

Bob