Article - Some doctors asking Medicare patients to switch plans

[Guest guest]

Interesting angle from this clinic.

 

Also, as usual, the comments section is always interesting.

Some blaming " Obamacare " for this particular problem (not related, IMHO), others blaming the doctors, others the gov't, etc.

 

http://community.seattletimes.nwsource.com/reader_feedback/public/display.php?thread=401597 & offset=80#post_2195043

 

Locke, MD

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http://www.highlinemedicalcenter.org/highline_medical_group/patient/important-notice-to.htm

  Important Notice to All Seniors

Our relationship with you is very important. As your health care provider, we want to make sure you get the care you need, when you need it. That is why we are asking that you switch to a Medicare Advantage plan during this fall’s annual election period.

In 2011, traditional Medicare is projected to cut its reimbursement by 30 percent, which will make it extremely challenging to sustain our practice in the future. Because of the uncertainty of Medicare reimbursement, we may not be able to continue to treat Medicare patients in 2011. Switching now to a Medicare Advantage plan will help ensure that you will be able to see us in the future. We know this is a hassle and we apologize. Many other physician groups across the nation are struggling with this same issue and have asked their patients to make a similar change.

We do believe that you will benefit from switching to a Medicare Advantage plan. There are a variety of coverage options, so you can choose which is best for you. Many offer additional services and benefits such as vision and dental. All of them limit your out-of-pocket costs and two of the plans have no monthly premium at all. Most importantly, you can continue to see your regular primary care provider while having access to Highline specialists and the services of Highline Medical Center.

We are asking you to change to a Medicare Advantage plan by December 31, 2010.

Questions about Medicare Advantage?

We know that Medicare coverage can be confusing. If you have questions, please contact our Patient Advocate, Bonnie Jennings, at ext. 246 or by email at info@....

You can also attend one of our free informational meetings to get all the answers to your questions. The meetings will be held on Highline Medical Center's Main Campus in Somer's Auditorium at the 3 Cedar Entrance. Highline Medical Center's Main Campus is located at 16251 Sylvester Rd SW in Burien, WA.

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http://seattletimes.nwsource.com/html/localnews/2013525407_medicaredocs26m.html

 

Some doctors asking Medicare patients to switch plans

Some local doctors, once again faced with a large cut in what the government pays them for treating Medicare patients, are telling senior patients they must switch by year's end to better-paying private Medicare Advantage plans.

, 72, was one of about 6,000 patients who recently received a letter from Highline Medical Group, a consortium of 35 doctors in eight clinics in the South Puget Sound area, telling them to switch plans by Jan. 1, when traditional Medicare reimbursements are set to shrink by 25 percent.

" It's kind of scary when your doctor sends you a letter saying 'I'm going to quit serving you,' " said , a retired Boeing research engineer. " I prefer traditional Medicare and want to stay on it, but feel I am being forced off. "

In the letter, doctors told the patients: " We know this is a hassle and we apologize. "

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Some argue that doctors could and should become more efficient. AARP state advocacy Director Ingrid Mc agrees that medicine must move from paying for " quantity " of care to paying for " quality and outcomes. "

" But in the interim, " she adds, " we cannot deny we will have a serious access problem if we cut doctors' pay under Medicare by 25 percent. It would be ugly. "

Ugly was what Highline Medical Group's administrator, Purcell, was trying to avoid.

" We really want to see patients, but we're having to ask them to get into something that will give us some kind of economic stability, " she said. " At some point, it's very hard to continue business. "

Many other clinics have encouraged or required seniors to switch to Medicare Advantage plans, she said, " primarily due to the differential in payment. "

Corgiat, spokeswoman for the Polyclinic, a large Seattle multi-specialty group, said Medicare Advantage plans also allow more flexibility in caring for chronically ill patients.

Some of The Polyclinic's 160 doctors still take patients on original Medicare, although most limit the number. If the cut goes through, The Polyclinic and other groups say they would have to stop accepting those patients.

For the doctors at Highline Medical Group, which is affiliated with Highline Medical Center, the financial situation is even more acute because they all practice primary-care medicine, unlike groups such as The Polyclinic that include specialists — typically better reimbursed by Medicare.

About 80 Highline patients become eligible for Medicare every month, Purcell said.

In the past, clinics have been able to compensate for low Medicare payments because most of their patients have private insurance that pays better, she said, but economic pressures have squeezed those payments, too. " This is a complex problem, " Purcell said of the payment system. " It's very broken. "

To keep their doctors, Highline's Medicare patients must pick one of six Advantage plans from three insurers — before Jan. 1. Many with original Medicare have a supplemental policy that helps pay their share of medical bills and they worry that once they cancel those supplemental plans they won't be able to get them back.

With federal subsidies to Medicare Advantage slated to start decreasing in 2011, many patients also worry that they'll pay more out-of-pocket.

In addition, the companies that run Advantage plans can close them as they see fit. And dozens of plans did close in Washington this year, leaving more than 40,500 seniors to find new coverage.

" We're between a rock and a hard place, " said Theresa Duke, whose husband is on traditional Medicare and doesn't want to lose his Highline doctor. Even if he switches to an Advantage plan now to keep his doctor, there's no guarantee, she says, that Highline will accept Advantage plans down the road. " Now I'm worried. "

, who attended one of a series of meetings Highline Medical Group is holding to help patients sort out their options, said he noted that the Medicare Advantage plans had lots of co-payments of various sizes.

" The co-pays are really weird, " he said, ranging from $5 to $50. " It got confusing. "

When he broke his wrist in August, Medicare covered the costs, with his supplemental, he said. If he'd been insured by the Advantage plan he's considering, he would have had seven or eight co-payments, he calculated. " It adds up to some serious money! "

, who's been seeing Highline doctors for 20 years, said he understands their dilemma and doesn't blame them for not wanting to lose money.

He and his wife will make the switch " just because I don't trust Congress, " he says. " We'll go with a Medicare Advantage plan and hope that a year from now, we're not sorry. "