AZ Mayo Clinic Drops Medicare 2010

Jan 5, 2010

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  1. MedSuppPro
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    The Mayo Clinic in Arizona will no longer accept patients who are on Medicare. Medicare patients are no longer going to be accepted due to the fact that the compensation paid out by Medicare is apparently not adequate to make up for the cost of care taken on by the clinic. If 3,000 Medicare patients who've been coming to the clinic want to keep seeing their same doctor, they'll have to pay cash up front.

    Mayo’s move to drop Medicare patients may be copied by family doctors, some of whom have stopped accepting new patients from the program, said Lori Heim, president of the American Academy of Family Physicians, in a telephone interview yesterday.

    “Many physicians have said, ‘I simply cannot afford to keep taking care of Medicare patients,’” said Heim, a family doctor who practices in Laurinburg, North Carolina. “If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.”

    I personally understand how paltry reimbursement rates lead to a cost imbalances and an inability to sustain a level of care for my clients. In my practice, I have stopped selling standalone Medicare PartD plans. During AEP I advised, but did NOT sell any PartD plans. Could this be a trend?

    Mayo Clinic Arrowhead Drops Medicare - Video - KPHO Phoenix

    Dear Patient,

    Changes are occurring at Mayo Clinic Family Medicine - Arrowhead that could affect your access to primary care. Please review the following information carefully:

    The discrepancy between what Medicare pays and our cost of providing care acutely impacts the sustainability of our primary care practice. Medicare reimbursements do not cover our actual costs of providing care, and therefore we have recently had to make some difficult decisions that will impact the Arrowhead Family Medicine practice. Effective January 1, 2010, the physicians at Mayo Clinic Family Medicine - Arrowhead will opt out of participating in Medicare, meaning that Medicare will no longer reimburse for the services they provide.

    Therefore, beginning January 1, 2010, your physician at Mayo Clinic Family Medicine - Arrowhead will no longer accept Medicare as reimbursement for your care. This change will not impact any other services provided at Arrowhead or any other Mayo facilities. Medicare will still be accepted for laboratory, X-rays, Anticoagulation Clinic and specialty care (such as Cardiology or Neurology) at Mayo Clinic.

    Because of this change, as a current Medicare patient, should you choose to continue receiving your primary care at Mayo Clinic Family Medicine - Arrowhead, you will be required to pay for your care out-of-pocket. Neither your physician nor you will be permitted to seek reimbursement from Medicare for care you receive. We will not be able to bill Medicare for the physician office visit services you receive at Arrowhead, nor will you be able to submit the bill to Medicare for later reimbursement. Again, laboratory, X-ray, and specialty services will remain covered. Only the office visit will change to an out of pocket expense.

    Costs you should anticipate paying out-of-pocket include:
    An annual administrative fee of $250 which will be collected each year. (This will cover the administrative expense of providing you with appropriate prescription refills and phone inquiries for minor needs as they arise throughout the year.)
    Normal fee rates for office visits. (Depending on the type of exam, fees may range from $175 to $400 per visit.)
    Patients will be expected to come into the office for the number of visits appropriate to their medical conditions, which include a complete physical exam at appropriate intervals. If you pay the administrative fee, have a physical, and come in three other times per year, your annual costs are estimated to be approximately $1,500.

    By maintaining your primary care with Mayo Clinic you will be assured continued care by a physician you know and trust. You will also have guaranteed access into primary care, an important resource that has become more difficult to obtain in recent years. In addition, by continuing your primary care with your Mayo Arrowhead physician, you will have continued coordinated specialty care at Mayo Clinic and be assured that your medical record will remain intact.

    To continue seeing your Mayo Clinic Arrowhead physician for your primary care please complete and sign the enclosed letter of agreement and bring it with you to your first appointment in 2010 along with the $250 administrative fee. If you have questions and would like to speak to someone directly about this change, please call Sue Stevens at 623-376-8985 to talk over the phone or to set up an appointment to meet in person.

    Unfortunately, you will not be able to transfer your primary care to another Mayo facility. However, you always have the choice of seeking primary care elsewhere in the community. If that is your choice, to assist you with this transition, we will forward a copy of your Mayo medical record to the office of your new physician, free of charge. To do this, a written request is required. Please complete the enclosed release of information form and return it to:

    Medical Records Department
    Attn: Theresa Ferrato
    Mayo Clinic
    13400 East Shea Boulevard
    Scottsdale, Arizona, 85259

    A partial list of family medicine physicians in the west Valley who are accepting new patients is included. Please contact the Maricopa County Medical Society at 602-252- 2015 or online at mcmsonline - Maricopa County Medical Society for an additional list of physicians.

    We are deeply sorry that we have had to make this decision in order to maintain access to primary care at Mayo Clinic in Arizona. While we know that change is difficult and can be disruptive, we hope that you will understand the challenges that have contributed to our need to make this decision. Throughout this and other changes we have made to our practice, we remain committed to being able to provide care to our patients.

    If you have questions regarding this transition or primary care at Mayo Clinic, please call Sue Stevens at 623-376-8985. We appreciate your understanding and we hope that you will choose to remain in our practice.

    Sincerely,
    Richard L. Engle, M.D.

    :err::err::err:
     
  2. somarco
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    somarco GA Medicare Expert

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    The AZ clinic is jettisoning primary care patients on Medicare. Those who see specialists will still have access without paying cash.

    This is not a fluke but a trend. Those who rely on taxpayer funded health insurance and hope to be on some kind of "public" plan will have to accept the fact that health care will be inaccessible to them.

    Obama's solution is to create more doctors.

    Not that easy.

    It takes 8 years minimum to be a doc and primary care, even without the low reimbursement of govt plans, is not lucrative. New grads are bypassing primary care in favor of a specialty where the earning power is 4x or more.

    In the meanwhile the boomer generation is graduating into Medicare creating even more demand. It is a train wreck waiting to happen.

    Clearly Washington has no clue what they are doing.
     
    somarco, Jan 5, 2010
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  3. Crabcake Johnny
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    I agree. How is "more doctors" a solution when the word's out that concentrating on Medicare patients results in a loss?

    That would be like the gov't trying to ram more engineers through college and offer them $22,000 a year instead of $60,000 through private companies.

    What exactly does the gov't have to OFFER new doctors?
     
  4. Justin Bilyj
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    They know fully what they are doing.
     
  5. motorcyclegogo
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    I thought all Mayo Clinics were already non-par with Medicare. I've had a client that sees the one in NY and all she has to do is file with Medicare and they pay the approved rate to her followed up by her supp and if she's on Plan G, like most of my clients are, F, or J then they get the appropriate share of the limiting charge paid back to them as well.

    My concern is: How can they say the patient can't file the claim with Medicare? I've had clients have the lap-band done and none of those clinics take Medicare... PERIOD. They client still gets to file with medicare and they get the ~$900 medicare allows plus the limiting charge if they are on a plan that has it. Seems to be the same issue here.

    BTW... this is G.Gordon using his wife's laptop at home. She's still getting ready for work.
     
  6. Crabcake Johnny
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    If someone put you in charge of GE's jet engine division tomorrow would you know what to do? That's what it's like for Congress to attempt to run the country.
     
  7. GreenSky
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    Medicare does not accept claims from patients, only from providers. If a non-Medicare doc treats a patient, then Medicare will accept a claim from that doc and certainly not from the patient.

    As far as your lap-band patients, there must have been some provider inside the clinic that filed something with Medicare. Perhaps the surgical center.

    Rick
     
  8. G.Gordon
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    Thinking on it further, maybe they did file with Medicare but held the patient liable for the $3750 differnce in the cost of the operation and what Medicare paid.
     
  9. retread
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    They can't file for Medicare reimbursement because they have chosen to refuse Medicare certification. Any provider not under Medicare certification will not be reimbursed by Medicare, and no healthcare provided by a non-certified provider will be Medicare approved. In other words, they have voluntarily put themselves on Medicare's blacklist.

    Also, a got in a conversation with a local M.D. at a Christmas party last month, and he told me he had already directed his staff that he will not be accepting any new Medicare patients effective Jan 1st. He also reported that many of his peers have done the same.
     
    Last edited: Jan 5, 2010
    retread, Jan 5, 2010
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  10. Jeff
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    Seems to me that the Dr.'s are sending a message to both the gov't and patients. Can you imagine the seniors reaction to getting dropped by their doctor because of Obamacare!
     
    Jeff, Jan 6, 2010
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