Monterey, CA Finding A Physician Who Will Take Medicare or Medi-Cal Continues To Be A Challenge

View From A Nonprofit Serving Carmel, Carmel Valley, Gonzalez, Greenfield, King City, Marina, Monterey, Pacific Grove, Pebble Beach, Salinas, Seaside And Soledad California The number of people on Medi-Cal is being expanded dramatically under President Obama's health care reform under the Affordable Care Act.  That's a good thing if people can find doctors which will take the insurance.  Because of extremely low reimbursement rates, many doctors shun those on Medi-Cal and it's extremely difficult to find a primary physician to take on someone who is on Medi-Cal.  According to a study in the journal Health Affairs which came out this month, 33% of primary-care physicians didn't accept new Medicaid patients in 2010 and 2011 (Medicaid is called Medi-Cal in California).  Even finding a physician who will take Medicare can be quite a task.  The Wall Street Journal reported that the number of doctors who opted out of Medicare nearly tripled from three years earlier.  Almost 10,000 doctors dropped out of the Medicare program and some are even dropping taking private insurance, going to concierge type services which are more lucrative for the physician.  This is sourced to data tracked by the Centers for Medicare and Medicaid Services, which also noted that some doctors are limiting the number of Medicare patients they treat but haven't yet dropped out of the program completely.  Currently, 20% of doctors say they won't accept new Medicare patients, up from 17% in 2010. In affluent markets like Monterey County, the problem is even worse.  The Medicare Rights Center said they are getting an increase in calls from seniors living in affluent areas which can't find a doctor who will take Medicare.  That’s because many living in the richer areas like Carmel and Pebble Beach can go to the concierge services and pay for the fees out of their own pocket.  This leaves less doctors practicing which will take on new Medicare and Medi-Cal patients.  It's a big problem here because there is such a huge variance in income and wealth levels in different parts of the county.  One of our Platinum sponsors, Alliance Home Health, faces this on a daily basis as they have a majority of their clients using Medicare or Medi-Cal insurance.  Thankfully, they take it.  Many medical providers won't.  Unfortunately, the problem may get even worse.  Unless Congress steps in, automatic budget cuts will go into effect in 2014 which will slash Medicare reimbursement rates by 25%.  This is just ridiculous and will likely encourage more physicians to start concierge services or go work for a hospital where they can get a decent salary.  Private practices just don't make much money anymore.