Medicare Patients in Northern Virginia Are Finding a Dearth of Physicians

By Chris L. Jenkins
Washington Post Staff Writer
Tuesday, December 9, 2008

Glenda Fried had heard the stories but never quite believed them. While she had had no problem getting her primary care physician in suburban Chicago to accept her Medicare health insurance, friends across the country were telling her about the devil of a time they were having. They talked of having to make at least 15 calls before finding a new primary care physician who participated in the taxpayer-funded medical insurance program largely for those 65 and older. Fried, 68, chalked it up to bad luck.

But when the retired school administrator moved to Chantilly this year to be closer to her son and his family, she realized there was some truth to the stories: Phone call after phone call was met with apologetic office mangers saying that Dr. X wasn't taking any new Medicare patients or Dr. Y wasn't taking any type of insurance at all.

"I must have made 12 calls before I could nail it down," she said recently. It took her a few weeks, she said, to find a physician she felt comfortable with. "One or two weren't taking new patients at all, but the vast majority were just not taking Medicare. And they were taking other forms of insurance."

Fried's experience is a growing concern among policymakers and health-care experts who envision a shortage of family medicine doctors and geriatricians to care for an aging population.

Health-care experts and advocates for the region's elderly say the problem is partly a reflection of how worried physicians are about changes in reimbursement rates from the federal government. Some physicians say they are afraid of accepting new Medicare patients and discovering later that the amount they receive for treating them will be decreased. Exacerbating those worries are concerns about the slow pace of reimbursement and the layers of paperwork it requires.

The nation's 44 million Medicare patients, on the other hand, tend to be satisfied with their treatment and are able to access care without delay once they have a physician, according to national surveys.

While statistics are not available for the D.C. region, the Medicare Payment Advisory Commission reported last week that nearly 30 percent of the 2.6 million Medicare beneficiaries seeking a new primary care physician between September 2007 and October 2008 had trouble finding one, up from 25 percent in 2005. To encourage primary care doctors to accept new Medicare patients, the commission recommended to Congress in June that it increase payments to those practitioners by redistributing payments for specialized care.

The group also found that Medicare patients seeking new primary care physicians were more likely to experience trouble finding one than those looking for specialists.

Zerline Chambers-Kersey, a primary care physician in Dumfries, said she decided last month stop taking new Medicare patients at her 9,000-patient practice. She said the delay in reimbursement and the constant worry that her rates might be cut were enough for her to also tell those currently on Medicare she would no longer see them after the end of the year. Even though she has only 150 Medicare patients now, she anticipated that this number would have grown to 600 next year because of the aging of her patients.

"It's just too frustrating," said Chambers-Kersey, who's been in practice by herself for 13 of her 25 years of experience.

"It's a business decision . . . a painful one, and in the middle my patients are the ones who feel it the most." She said she is helping her affected patients find new doctors who take Medicare as she informs them of her decision.

In the National Report Card on the State of Emergency Medicine released today, the American College of Emergency Physicians says that for every 100 Medicare beneficiaries, the District has 11.3 physicians who accept this coverage, a higher rate than any of the states.

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