Kelsey Seybold Clinic, Houston's largest internal medicine group, opts out of traditional Medicare..

[Faryn Balyncd]

Kelsey Seybold Clinic is one of the largest Medicare provider's in the United States.

Kelsey-Seybold group opts out of Medicare
By CINDY GEORGE Copyright 2009 Houston Chronicle


The Houston area’s largest private physician group will no longer treat patients who pay for services through traditional Medicare.

Kelsey-Seybold Clinic stopped accepting the government health insurance program for older Americans on Jan. 1 and asked patients to switch to one of three private Medicare Advantage plans or find new doctors elsewhere.

Dr. Spencer Berthelsen, Kelsey-Seybold chairman, said the clinic opted out of traditional Medicare because reimbursements have fallen below the cost of providing care.

About 90 percent of Medicare patients who receive the majority of their care at Kelsey-Seybold’s 18 clinics — roughly 20,000 people — have switched to the private plans, Berthelsen said.

About two years ago, Kelsey-Seybold began shepherding Medicare patients into Medicare Advantage plans, which sometimes require additional premiums and restrict patients to a network of doctors.

The plans, however, reduce other out-of-pocket costs associated with traditional Medicare.

The Centers for Medicare and Medicaid Services raised this year’s physician payments by 1.1 percent, far less than the increased cost of doing business, doctors say.

“What we knew for sure is that if we were to stay in the traditional Medicare program, we were facing a deteriorating situation,” Berthelsen said.

Kelsey-Seybold’s move follows a decade-long national trend of doctors dropping or limiting the number of traditional Medicare patients, most of whom are 65 or older. A recent Texas Medical Association survey found that only 64 percent of doctors statewide will accept all new Medicare patients who seek their care, down from 78 percent in 2000.

According to the Kaiser Family Foundation, 23 percent of Medicare beneficiaries nationwide were enrolled in Advantage plans last year. About 17 percent of Medicare-eligible Texans have chosen the private plans.

About 2,000 Kelsey-Seybold patients decided not to switch to Advantage plans and must find new doctors. Some in the middle of treatment were given an April 1 deadline to decide.

Among them is Stanley Merriman’s disabled grown son. Merriman said he opted not to switch and will try to reinstate his son with the Harris County Hospital District.

“That’s probably going to be our only alternative unless we luck into finding a private practitioner who accepts Medicare,” said Merriman, a retired health care consultant.........



http://www.chron.com/disp/story.mpl/front/6268167.html

[peacetalksforall]

1. Health in this country is sick.

[old mark]

2. Does anyone know what an average hourly rate of pay would be

for a MD, DO, etc? I am certain there is some sort of guideline set by the AMA but I have no idea what it is.

I do not subscribe to the idea that all doctors should become rich, but I am sure most doctors do.

mark

[musette_sf]

3. "Medicare Advantage" - Bu$hSpeak lives on

Medicare Advantage plans, which sometimes require additional premiums and restrict patients to a network of doctors.

and this is an "advantage" HOW???

[CountAllVotes]

4. fools

Medicare reimbursement along with what some supplemental plans pay along with it might be looking damn good to these idiots very soon as people won't be going near doctors when times are bad. I hope this comes back to bite them in the ass!!

:kick:

[predfan]

5. So much for that Hippocritical Oath..............

[kestrel91316]

6. This is why we need to remove the bloodsucking parasites from

the healthcare system.

NO MIDDLEMEN!!! Let our dollars go to the hardworking human beings who actually provide patient care and facilities maintenance and whatever. Beancounters and paperpushers are sucking the lifeblood out of out healthcare system.

SINGLE. PAYER. NOW.

[ayeshahaqqiqa]

8. Yes yes!

I'm sick and tired of the beancounters giving us a hard time about medications Doc has prescribed. I know one time we went round and round with this for over a week, telling the IDIOTS that if we gave the patient the Rx they wanted to give her, she'd have an allergic reaction and DIE! That didn't matter.

As for doctors making big bucks--like any profession, you have your MDs who make out like bandits, and MDs who work for a pittance. My Doc fits the latter category.

[ayeshahaqqiqa]

7. Medicare will also not cover all treatments

but if you treat one Medicare patient and ask for reimbursement, Medicare can audit all your files. We opted out of Medicare long ago--we treat folks for a donation only, even if the donation is a smile.