Anchorage Medicare clinics short of patients

Offices opened when doctors began refusing older people.

Anchorage Daily NewsJanuary 29, 2012 

Medicare patients flooded two new clinics targeting the older population when they opened in Anchorage last year -- most other primary care doctors wouldn't take the federal insurance for seniors because they say Medicare pays too little.

Recently, the demand to get into the clinics has eased, and clinic officials are beginning to wonder: What happened to the rest of the Medicare patients? Are they finding doctors Outside where they go in winter? Are they seeing specialists like cardiologists and pulmonologists for all of their needs? Are they just not sick?

Combined, Providence Senior Care Center, which opened a year ago this week, and the Alaska Medicare Clinic in South Anchorage, opened in May, have seen nearly 3,000 patients so far -- far fewer than the estimated 8,000 to 10,000 Anchorage Medicare recipients who were believed to be without primary care doctors last year.

"We may have met the need with the loudest voice," the people with immediate needs, said Dr. Tom Hunt, director of physician services for Providence Alaska Medical Center. The Providence senior clinic takes patients 55 years old and up. Medicare is available to those 65 and older, as well as to some younger people with disabilities.

Dr. George Rhyneer, a retired cardiologist who spearheaded creation of the nonprofit Medicare clinic in South Anchorage, said he thinks a lot of specialists stepped in to treat patients for primary care needs -- the flu, high blood pressure, diabetes -- at a time when the patients couldn't find regular family doctors. Many may be satisfied with that approach, and stuck to it, Rhyneer said.

There have been no recent studies of how Medicare patients are being served, or not served, so ideas about what's going on with them are speculative, said Mark Foster, a health care analyst and consultant to the University of Alaska Anchorage's Institute of Social and Economic Research.

Rita Hatch, a Medicare specialist at the Older Persons Action Group, said she used to regularly survey doctors' offices to see if they were accepting new Medicare patients, or keeping patients that aged into Medicare, but she quit doing it because not many Medicare recipients are calling looking for doctors.

"A year ago I was getting tons of calls," she said.

If people call now, she gives them the names of the two new clinics, and also Anchorage Neighborhood Health Clinic, a community clinic that accepts all patients, including those on Medicare, and has recently begun expanding its patient load.

Rhyneer thinks many people haven't heard of the South Anchorage clinic yet, despite its advertising. Most new patients hear about it from others who have been there, he said.

The two new clinics have a different focus, but both need more patients to break even.

The Alaska Medicare Clinic, on the Old Seward Highway near O'Malley Road, has one doctor, but streamlines care by having three teams each consisting of a registered nurse and a medical assistant do some of the time-consuming work that doctors often do in other clinics, such as getting a detailed medical history.

The break-even point will be 45 patients a day, said Rhyneer. The average so far is about 25, with 1,400 patients visiting the clinic so far.

Rhyneer said during a health conference presentation this week that his clinic does well with what he and other conference participants called "go-go" and "slow-go" seniors. A third category the health conference speakers referred to are "no-go" seniors.

The Providence clinic views itself as a comprehensive medical home for patients at all levels of health.

The Providence clinic has been doing hour-long new-patient appointments "to attend to deferred maintenance," said Hunt, and that slowed intake. At one point there was a six-week waiting list to get a first-time appointment. Now it's two weeks, he said. Rhyneer said a patient can get a next-day appointment at the South Anchorage clinic.

While at first Providence was expecting as many as 5,000 patients the first year, they've seen only 1,500, Hunt said.

"I still don't think we've met the unmet needs," he said.

Even if demand has slowed for the moment, nobody expects that to last over the long-term. The number of senior citizens in Alaska is rising rapidly -- by seven percent from 2009 to 2010, according to the Alaska Commission on Aging. Alaskans 60 and older are the fastest growing segment of the state's population. That group grew at a rate of 71 percent from 2000 to 2010, says a commission report, from 53,026 people in 2000 to 90,876 in 2010.


Reach Rosemary Shinohara at rshinohara@adn.com or 257-4340.

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