Doctors not taking Medicaid

Some Naples doctors with Anchor Health stop taking new Medicare patients

By LIZ FREEMAN

Monday, March 8, 2010

NAPLES — Judith Formichella tried to get an appointment Monday with a particular physician at Anchor Health Centers, with no luck.

It isn’t because she is uninsured. She has Medicare and a top-of-the-line supplemental policy.

But a 21 percent Medicare reimbursement cut is causing doctors to turn away new Medicare patients.

Originally from Pennsylvania, Formichella is spending the winter in Naples.

“I’m angry at the doctors. I am angry at the politicians who are not making a good-faith effort,” Formichella, 67, said. “Medicare is just a small piece of a broken health-care system. You’ve got the lobbyists fighting to keep the status quo and the insurance companies making a fortune.”

Eight to 10 primary-care physicians with Anchor have decided to temporarily stop accepting new Medicare patients because of the reimbursement cut that was scheduled to take effect March 1. Congress last week delayed the cut until April 1.

Physicians nationwide are fed up that Congress won’t permanently fix a flawed reimbursement formula for Medicare that results in a proposed cut, of a varying amount, each year. Typically at the final hour, Congress acts to overturn the cut to keep the status quo rather than coming up with a new funding formula, which the American Medical Association lobbies for every year.

“I’m a victim and how many are out there?” Formichella said. “I can’t call and make an appointment? I don’t think I’m asking too much.”

Formichella ended up in a walk-in clinic and waited three hours to see a physician. She was equally outraged at an earlier suggestion that she go to a hospital emergency room. She pays $400 a month for Medicare, another $300 a month for her supplemental policy with Blue Cross and Blue Shield, and another $300 a month for her Medicare drug plan.

“Now we are told to go to a clinic or go to an emergency room because I can’t get a doctor here. Is that what we call the best health care in the world?” she asked.

Bill Edwards, chief executive officer of the 67-physician Anchor, the largest group practice in Collier County, said the eight to 10 primary-care physicians made the decision last week. All told, Anchor has 25 primary-care physicians.

Unless Congress acts to fix the Medicare formula, called the sustainable growth rate, which sets an annual target for Medicare spending on physician services, Edwards said more physicians could follow suit, within Anchor and elsewhere.

“I think certainly in the event the fees are reduced, we will see more primary-care physicians decide to do the same,” Edwards said. “There is the risk that physicians will band together and organize in a more coordinated fashion to effect meaningful change in the way physicians are paid and reimbursed.”

All told, Anchor has 150,000 active patients and about 85,000 of them are Medicare patients, he said.

So far, Anchor hasn’t been tracking how many new Medicare patients are being turned away, because they will get referred to someone else in Anchor who still is accepting Medicare or put on a waiting list if they have singled out a doctor who isn’t accepting Medicare now, he said.

Edwards said the concern is the funding system won’t get fixed and Medicare patients will lose access to medical care, and that’s the message that physicians have been relaying to members of Congress for months.

“These (Anchor) physicians have made this decision and we support them. We support their right to make this decision,” Edwards said.

Last week, physicians in Palm Beach County staged a protest against the Medicare cut and physicians in Manatee County will hold a rally in the near future, said Margaret Eadington, executive director of the Collier County Medical Society.

Members of the Collier medical society discussed the idea of a rally but decided against it, she said.

Dr. Charles Anderson, past president of the medical society and an internist with Anchor, said physicians are on edge because of the proposed cut and Congress’ failure to permanently resolve the reimbursement formula. Anderson is still accepting new Medicare patients.

Locally, physicians may think again and decide to hold a rally if Congress doesn’t act, he said.

“Many of us would like to protest,” Anderson said.

Connect with health-care reporter Liz Freeman at www.naplesnews.com/staff/liz_freeman