Health Care Crisis: Fewer doctors accepting Medicare patients
On Medicare and now find yourself a "second class" citizen?
From Frank Kaiser, Suddenly Senior
Published: Wednesday, July 12, 2006
By DAN JOHNSON
ARGUS-COURIER STAFF
Marie Hite recently found herself in quite a quandary.
She had been seeing a doctor in Petaluma who accepted her Medicare coverage, but the doctor moved her practice to Novato. Hite would have liked to begin seeing one of the other two doctors in the office, but one retired and the other became exclusively an in-house doctor at Petaluma Valley Hospital.
Hite has medical coverage from both Medicare and Georgia State University, but had a difficult time finding a doctor in Petaluma who would accept new Medicare patients, and they wouldn't honor her Georgia State coverage because they regarded Medicare as her primary insurer.
Finally, she discovered Rajesh and Rajina Ranadive, a young, married couple with a practice at 161 Lynch Creek Way.
"They're the only option in Petaluma for Medicare patients, and some of the main local specialists don't seem to have a working relationship with them," said Ann Foletti, Hite's daughter. "Some doctors in Novato, Santa Rosa and other nearby cities accept new Medicare patients, but they need to be able to drive to get there.
"For some people, it's a tragic situation."
The shortage of doctors receiving new Medicare patients is largely due to the relatively low reimbursement rate in southern Sonoma County. In November, federal officials rejected a proposal that called for Sonoma County primary physicians' reimbursement rates to be increased by 8 percent because the county is becoming more urban and now has a higher cost of living.
In December, federal officials eliminated a 10 percent reimbursement bonus that primary-care doctors in Petaluma, Cotati and Rohnert Park formerly were given, saying those cities no longer suffer a similar doctor shortage as portions of the Russian River area, Sonoma Valley and Cloverdale.
"So, doctors now actually lose money by treating Medicare patients," said Daymon Doss, CEO of the Petaluma Health Care District. "As a result, thousands of the 10,000 to 12,000 people eligible for Medicare in south Sonoma County are looking for a doctor.
"Every office they call is closed or not accepting new Medicare patients. People express their frustration to me all the time. Only the Ranadives are accepting new patients."
The Ranadives will be adding a pulmonologist and family physician internist in August, as well as two nursing practitioners. Doss says this will slightly help the situation.
"The Medicare situation will be a continual problem," he said. "We need to redouble our recruitment efforts so that we can bring three to four internal-medicine physicians to Petaluma in the next two years."
Recruiting poses an enormous challenge, however, partially due to the high cost of living and low reimbursement rates.
Wayne Fairchild, vice president of operations at PVH, feels the federal government needs to develop a better understanding of the Medicare dilemma facing Petaluma and many other communities around the country.
"It worries me, and I don't think anything will change until Congress acts on the matter," he said. "The California Medical Association and other groups need to lobby Congress."
"The whole health-care package needs to be re-examined," Doss added. "But for us in Petaluma, it's particularly frustrating that doctors across the Marin County line receive better reimbursement rates."
posted by Kathie Bracy at 7:56 PM
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