WICHITA, Kan. (KWCH) - Some Medicare patients in Wichita find it increasingly difficult to find a new primary care physician., as some physicians are deciding not to accept these new patients because of the low Medicare reimbursement rate for physicians.
Medicare is the federal health insurance program available to people 65 and older.
“We get called every day from people wanting help finding physicians, and many of those are Medicare patients, and we’ve seen, increasingly, it’s difficult to find a primary care physician that’s able to see new Medicare patients,” said the Medical Society of Sedgwick County Executive Director Phillip Brownlee.
Brownlee told 12 News that in some cases, MSSC refers people as far away as Hesston. Some practices say they’re unable to see patients until December 2024.
It all comes down to an issue of access.
“It’s becoming harder and harder, and as our population ages, the more people that get on Medicare, the problem will continue to get worse unless there’s some help from Congress,” he said.
Dr. Howard Chang, M.D. is an Emergency Medicine Physician and President of MSSC. He said it’s a difficult decision for physicians not to accept a new Medicare patient.
“It’s gut-wrenching, actually,” said Dr. Chang. “One of my best friends is a family physician and his practice is about 30 percent Medicare, and he says he can’t take any more. He lives in a more rural area of the country, and he can’t take anymore because he can’t afford to. It just doesn’t pay the bills, and he would just be losing money at this point. He’s barely breaking even.”
Dr. Chang said for physicians, Medicare has established rates of what they’re willing to reimburse, so when a doctor like him submits a bill to Medicare, they’ll get back an x-number of dollars, and they’ll have to take.
“This actual dollar amount is something that physicians have to sort of fight for year after year. It’s a constant issue with reimbursement,” said Dr. Chang. “If you look at the way physicians have been reimbursed since 2001, once you’ve adjusted for inflation, there’s actually been a 30 percent decrease in physician reimbursement for Medicare patients.”
Medicare reimbursement rates for physicians have been relatively flat for about 20 years, but last year saw a two percent decrease. They decreased another 3.4 percent this year until the latest budget Congress passed mitigated some of that, but the decrease will still be about 1.7 percent.
Dr. Chang said the overhead costs for a physician operating a practice are increasing.
“Every time you see a Medicare patient, you lose money, so we’re just trying to lose less money per patient,” he said.
Brownlee said physicians want to care for patients, but as the population ages, access becomes another issue.
“That’s why they became physicians, but they also have to run a practice, and without getting adequate reimbursement, that becomes very difficult,” he said.
When Dr. Chang and other members of MSSC were in Washington, D.C., in February, they brought this issue up with the staff of Kansas lawmakers.
When they returned, they decided to add more understanding to this issue.
In a point-in-time survey to their members, of the 161 primary care physicians to respond, only 31 are accepting new Medicare patients.
“Only 20 percent were taking new patients, and even in some of those cases, it may be just a couple patients, or the wait may be long to get in actually see them,” Brownlee said.
Medicare patients are often older, which Dr. Chang said means they likely have complicated cases that are harder to manage -- and that means more resources.
“If you’re not going to be paid to do all that work, why would you accept that when you can get a healthy 35-year-old who works Textron with good insurance?” said Dr. Chang.
He and Brownlee said part of their push to Congress is to use the same reimbursement process that Medicaid has for hospital facilities and other providers.
“We should be treated the same as hospitals and other providers so that there would be an automatic increase based on the inflation index that Medicare uses,” said Chang. “If they would have done that this year, for example, the increase to physicians would have been 4.6 percent, rather than the 3.4 percent cut that physicians received.”
MSSC and the Kansas Medical Society are also pushing for an increase in state-set Medicaid reimbursement rates. The Kansas House and Senate have included funding the budget proposal to provide those increases.
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