oldenGoldenDecoy's picture

    Glaivester's Impressions on Doctor's Refusal of Medicare Patients


     Uh . . . where to start?


    Dear Glaivester:

    Related to your comment in Matt Miller's thread.

    Maybe a little more investigation and reading on your part may change your "impression."

    First up: Make sure you wander over into my blog see this post:

    Health Insurers: Screwing Doctors and the Patients at the Same Time?


    Now that doesn't specifically cover the Medicare doctor problem, although if the doctors are pissed off enough over non-payments in the regular coverage, then it most likely would spill over to the Medicare payments also.

    To continue, Glaivester said:

    "I  am under the impression that a lot of doctors don't take Medicare cases because they fell that the amount that the government pays is not enough."


    Well ... If we are going to speak about impressions, I'm under the "impression" that a large part of the problem is that doctors are not taking Medicare patients that are covered by the "MedicarePart C - Medicare Advantage Plans" that are administered by guess who -- private corporate insurance companies.

    "Medicare Part A: Hospital Insurance and "Medicare Part B: Medical Insurance patients aren't having the same problem with doctors not taking them.


    And it's all not simply a "black and white" situation, There are various problems involved:

    "Part C - Medicare Advantage Plans" (wiki)

    Each year many individuals disenroll from MA plans. A recent study noted that about 20 percent of enrollees report that 'their most important reason for leaving was due to problems getting care.'[13] There is some evidence that disabled beneficiaries 'are more likely to experience multiple problems in managed care.'[14] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans.[15]

    [13] "Problems encountered by Medicare beneficiaries in managed Care plans," >Booske B, Frees D, etc., AcademyHealth, Abstr Academy Health Meet. 2005, 22: abstract no. 3625.

    [14]"Voluntary disenrollment from Medicare managed care: market factors," (pdf) Mobley L, et al., Health Care Financing Review, 2005 Spring; 26(3): 45-62.

    [15] Hellinger FJ, "The effect of managed care on quality: a review of recent evidence," Archives Internal Medicine, 1998 Apr 27; 158(8): 833-41..

    Plus don't overlook:

    [16] Christelle Chen, "LOW-INCOME & MINORITY BENEFICIARIES IN MEDICARE ADVANTAGE PLANS, 2006," (pdf) America's Health Insurance Plans, September 2008

    [17] "Insurers Fight to Defend Lucrative Medicare Business," Wall Street Journal, April 30, 2007


    Hmmm ...

    I Wonder what the problem is with the doctors and why they wouldn't want to take those patients covered through the Part-C Advantage plans? (note: sarcasm)

    And as I said at the beginning: Maybe a little more investigation and reading on your part may change your "impression."


    ~OGD~


    Latest Comments