Seniors frustrated with docs who reject Medicare

PORTLAND, Ore. – Doctors who are unable to accept new patients on Medicare has been another headache for seniors in the area.

Arlene Brandenburg is one of those having trouble searching for a new doctor.

“Turn 65, you’re on Medicare. Now if the doctors aren’t going to see you, what are you going to do?” asked Brandenburg. “Sit on the corner until you die?”

Medicare uses a formula to compute reimbursements for doctors.

The important part of the formula is GPCI, which represents medical costs in a particular geographical area since 1966. Although Oregon and Washington have a history of being efficient, the efficiency is not so good when it comes to reimbursements.

The national average reimbursement for doctors per patient is $5,490. In Washington, D.C., the amount is $10,373. But in Oregon, it’s only $3,829. Oregon doctors only get about 80 percent of the true cost of their services.

“If you only have Medicare and Medicaid patients in your office as a primary care doctor, it’s very hard to pay your bills and keep your office open, so you require a certain number of commercial patients,” said Dr. Peter Bernardo, president of the Oregon Medical Association.
 
Because of the low reimbursements, Oregon and Washington have a hard time attracting new doctors, which only makes the problem worse.

Several western states with smaller populations are affected, but those same states have lacked the political power to make changes. Oregon is among the bottom 10 states in the country.

“I am going to pull out all the stops in this health reform debate to get this changed so that states like Oregon that provide real value for the Medicare health dollar get rewarded rather than penalized,” said Sen. Ron Wyden, D-Oregon.

But Brandenburg said she won’t be staying in Oregon to find out.

“I’ll be moving out of the state,” she said. “There’s no doubt about it. I will be out of state.”