Mayo Clinic To Stop Treating Some Medicare Patients in Arizona
January 6, 2010
Bloomberg.com
By David Olmos
The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.
More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota.
Obama in June cited the nonprofit Rochester, Minnesota-based Mayo Clinic and the Cleveland Clinic in Ohio for offering “the highest quality care at costs well below the national norm.” Mayo’s move to drop Medicare patients may be copied by family doctors, some of whom have stopped accepting new patients from the program, said Lori Heim, president of the American Academy of Family Physicians, in a telephone interview yesterday.
“Many physicians have said, ‘I simply cannot afford to keep taking care of Medicare patients,’” said Heim, a family doctor who practices in Laurinburg, North Carolina. “If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.”
Medicare Loss
The Mayo organization had 3,700 staff physicians and scientists and treated 526,000 patients in 2008. It lost $840 million last year on Medicare, the government’s health program for the disabled and those 65 and older, Mayo spokeswoman Lynn Closway said.
Mayo’s hospital and four clinics in Arizona, including the Glendale facility, lost $120 million on Medicare patients last year, Yardley said. The program’s payments cover about 50 percent of the cost of treating elderly primary-care patients at the Glendale clinic, he said.
“We firmly believe that Medicare needs to be reformed,” Yardley said in a Dec. 23 e-mail. “It has been true for many years that Medicare payments no longer reflect the increasing cost of providing services for patients.”
Mayo will assess the financial effect of the decision in Glendale to drop Medicare patients “to see if it could have implications beyond Arizona,” he said.
Nationwide, doctors made about 20 percent less for treating Medicare patients than they did caring for privately insured patients in 2007, a payment gap that has remained stable during the last decade, according to a March report by the Medicare Payment Advisory Commission, a panel that advises Congress on Medicare issues. Congress last week postponed for two months a 21.5 percent cut in Medicare reimbursements for doctors.
National Participation
Medicare covered an estimated 45 million Americans at the end of 2008, according to the Centers for Medicare & Medicaid Services, the agency in charge of the programs. While 92 percent of U.S. family doctors participate in Medicare, only 73 percent of those are accepting new patients under the program, said Heim of the national physicians’ group, citing surveys by the Leawood, Kansas-based organization.
Greater access to primary care is a goal of the broad overhaul supported by Obama that would provide health insurance to about 31 million more Americans. More family doctors are needed to help reduce medical costs by encouraging prevention and early treatment, Obama said in a June 15 speech to the American Medical Association meeting in Chicago.
Reid Cherlin, a White House spokesman for health care, declined comment on Mayo’s decision to drop Medicare primary care patients at its Glendale clinic.
Medicare Costs
Mayo’s Medicare losses in Arizona may be worse than typical for doctors across the U.S., Heim said. Physician costs vary depending on business expenses such as office rent and payroll. “It is very common that we hear that Medicare is below costs or barely covering costs,” Heim said.
Mayo will continue to accept Medicare as payment for laboratory services and specialist care such as cardiology and neurology, Yardley said.
Robert Berenson, a fellow at the Urban Institute’s Health Policy Center in Washington, D.C., said physicians’ claims of inadequate reimbursement are overstated. Rather, the program faces a lack of medical providers because not enough new doctors are becoming family doctors, internists and pediatricians who oversee patients’ primary care.
“Some primary care doctors don’t have to see Medicare patients because there is an unlimited demand for their services,” Berenson said. When patients with private insurance can be treated at 50 percent to 100 percent higher fees, “then Medicare does indeed look like a poor payer,” he said.
Annual Costs
A Medicare patient who chooses to stay at Mayo’s Glendale clinic will pay about $1,500 a year for an annual physical and three other doctor visits, according to an October letter from the facility. Each patient also will be assessed a $250 annual administrative fee, according to the letter. Medicare patients at the Glendale clinic won’t be allowed to switch to a primary care doctor at another Mayo facility.
A few hundred of the clinic’s Medicare patients have decided to pay cash to continue seeing their primary care doctors, Yardley said. Mayo is helping other patients find new physicians who will accept Medicare.
“We’ve had many patients call us and express their unhappiness,” he said. “It’s not been a pleasant experience.”
Mayo’s decision may herald similar moves by other Phoenix- area doctors who cite inadequate Medicare fees as a reason to curtail treatment of the elderly, said John Rivers, chief executive of the Phoenix-based Arizona Hospital and Healthcare Association.
“We’ve got doctors who are saying we are not going to deal with Medicare patients in the hospital” because they consider the fees too low, Rivers said. “Or they are saying we are not going to take new ones in our practice.”
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Doctors’ Deal With Coke Creates Uproar
November 9, 2009
Associated Press
By Lindsey Tanner
Advice about soft drinks and health from one of the nation’s largest doctors groups will soon be brought to you by Coke.
The American Academy of Family Physicians has prompted outcry and lost members over its new six-figure alliance with the Coca-Cola Co. The deal will fund educational materials about soft drinks for the academy’s consumer health and wellness Web site, http://www.FamilyDoctor.org.
Academy CEO Dr. Douglas Henley said Wednesday that the deal won’t influence the group’s public health messages, and that the company will have no control over editorial content. He said the new online information will include research linking soft drinks with obesity and will focus on sugar-free alternatives.
But critics say the Coke deal will water down the advice.
“Coca-Cola, like other sodas, causes enormous suffering and premature death by increasing the risks of obesity, diabetes, heart attacks, gout, and cavities,” Harvard University nutrition expert Dr. Walter Willett said in an e-mail.
He said the academy “should be a loud critic of these products and practices, but by signing with Coke their voice has almost surely been muzzled.”
Dr. Henry Blackburn, a University of Minnesota public health specialist, said the deal “will inevitably have a chilling effect on the focus of their message in regards to sweet drinks.”
Coca-Cola spokeswoman Diana Garza Ciarlante said that kind of criticism “misses the point of the partnership which is to provide education based on sound science.”
Dr. William Walker, public health officer for Contra Costa County near San Francisco, likened the alliance with ads decades ago in which physicians said mild cigarettes are safe,
Walker has been a member of the academy for 25 years but quit last week. He said 20 other doctors who work with his local medical practice also quit because of the Coke deal.
In an announcement last month, the academy, based in suburban Kansas City, Kan., said the new Coca-Cola-funded educational material will be posted online in January.
The idea is “to develop educational materials to help consumers make informed decisions so they can include the products they love in a balanced diet and healthy lifestyle,” the academy’s president-elect, Dr. Lori Heim, said at the time.
The American Academy of Pediatrics received similar criticism seven years ago when it allowed an infant formula maker’s logo to appear on copies of that group’s breast-feeding guide.
And the American Medical Association faced harsh reaction more than a decade ago with a plan to endorse Sunbeam appliances without testing them. Criticism forced the AMA to abandon that deal.
The Coke deal is not the only corporate alliance for the family physicians group. In 2005 it received funding from McDonalds for a fitness program. And its consumer Web site includes advertising for a variety of products, including deli meats and air freshener.
Henley said the Coke deal is worth six figures but he and a Coca-Cola spokeswoman declined to elaborate.
In a protest letter to Henley, 22 health specialists and activists questioned the safety of artificial sweeteners and urged the academy to abandon the deal and speak out against sugary drinks “in the strongest language.”
Henley said the academy regrets the resignations and hopes other members will not “rush to judgment” before seeing the new content.
Coca-Cola is among several corporate contributors to the American Academy of Family Physicians Foundation, a separate philanthropic group. These contributors include many drug companies, McDonalds, PepsiCo and a beef industry group. Henley said the academy is in talks with other foundation contributors to fund other materials for the group, but he declined to say which ones.
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