Alaska Regional Senior Health Clinic, which states its mission is “to serve Alaska’s Medicare beneficiaries with the care and respect they deserve,” has decided to roll up its practice in a most disrespectful way. Contrary to Regional’s characterization, elders are not “beneficiaries” of Medicare. They are “insured” by Medicare, deserving of essential medical care in exchange for contributions made throughout their careers and now, through monthly Medicare premiums.
Regional cited staffing issues, but that appears somewhat suspect. In 2009, the UAA Institute of Economic and Social Research identified this problem: “Only a handful of primary-care doctors in Anchorage will see new Medicare patients, and a significant number in the Mat-Su Borough and Fairbanks are also declining new Medicare patients. Nearly two-thirds of older Alaskans live in those areas. The access problem is much worse in Anchorage than it is nationwide; about 60% of primary care doctors in the U.S. as a whole will accept new Medicare patients. Doctors outside Alaska’s largest urban areas will still typically see new Medicare patients. Most doctors (even in Anchorage) will still see their established Medicare patients. Doctors overwhelmingly cite inadequate pay as a major reason for turning away Medicare patients, but it’s not the only one—half also say they also have problems with Medicare’s billing requirements and that Medicare patients pose too high a clinical burden.”
Since 2009, we’ve learned more. First, Anchorage has more elders seeking primary care. Second, Medicare rates do not keep step with the cost-of-service delivery, or more providers would serve the population. Third, today not even a handful of doctors will see new Medicare patients. According to Medicare.gov, there are a whopping seven Medicare general practice providers who accept non-Native Medicare patients in Anchorage. However, phone calls to their offices slowly yield that none of them accept new Medicare patients. In fact, there are now only two clinics in Anchorage accepting these patients. Fourth, most primary care doctors in Anchorage are not continuing to see their patients when they switch to Medicare coverage. Many “fire” their Medicare patients when they turn 65.
This leads to more costly and truly inhumane results. Elders who can’t access primary care must wait for a crisis and use hospital emergency rooms. Elders who need specialty care do not receive it since a primary care referral is required by Medicare for this. Elders who receive no preventive care live shorter lives. Staffing may have posed some challenges here as everywhere. This is, however, mainly a problem of low government reimbursement rates that providers are allowed to reject, compared with the lush reimbursement rates of private insurance for which they vie.
— Stephanie Rhoades
Anchorage
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