David Hogberg: The Next Exodus: Primary-Care Physicians and Medicare

In late 2009 the highly respected Mayo Clinic grabbed national headlines when it announced that one of its primary-care centers was no longer accepting Medicare. Henceforth, Medicare patients visiting its family clinic in Glendale, Arizona would have to pay cash. In 2008 Mayo lost $120 million on Medicare patients at all of its Arizona facilities. At the Glendale clinic, Medicare had covered only about half of the clinic’s expenses for treating the elderly.

When physicians limit their exposure to Medicare by either dropping out of the program or restricting the number of Medicare patients they treat, it seldom receives any press coverage beyond local media, if it receives any coverage at all. Nevertheless, physicians’ growing reluctance to accept Medicare patients is becoming a serious problem. If this budding crisis has an epicenter, it appears to be Texas. “Texas Doctors Fleeing Medicare in Droves,” blared aHouston Chronicle headline. Data compiled by the newspaper found that Texas physicians were dumping Medicare at a rate of about 100 to 200 per year. In 2010 a Texas Medical Association survey found that 18 percent of the state’s physicians were restricting the number of Medicare patients they treated, while 16 percent were no longer seeing new Medicare patients.

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