Alaska News

City doctors turn away new Medicare patients

Only 13 of 75 primary care doctors surveyed in Anchorage are willing to accept new Medicare patients, according to a study by the Institute of Social and Economic Research at the University of Alaska Anchorage.

And only five primary care doctors here who accept new Medicare patients are in private practice. The rest work in publicly supported health care centers or limited service urgent-care clinics.

"There's a major problem in Anchorage," wrote study co-authors Mark Foster and Rosyland Frazier -- who interviewed 229 primary care physicians or their staff members statewide.

"As more Alaskans turn 65, the access problem will get worse, unless something changes."

Stories are increasingly told of Anchorage doctors refusing to accept new patients on Medicare, which pays them about two-thirds as much as private insurance companies pay them. But those reports have mostly been anecdotal. Now the ISER study says they're mostly true.

The same problem prevails to a lesser extent in Fairbanks and the Matanuska-Susitna Borough, the study found. In Mat-Su 11 of 26 doctors surveyed won't accept new Medicare patients. In Fairbanks, seven out of 23 do not.

However, almost all doctors surveyed in smaller cities and rural Alaska -- 84 out of 87 doctors -- accept new Medicare patients.

"Rural places have few doctors, so (they) probably feel more of an obligation to see all patients," the authors wrote.

Most of the 62 primary care physicians in Anchorage who refuse to accept new Medicare patients -- 42 of them -- bend their own rules for longtime patients who "age in" to Medicare, the survey found.

But 20 of the 75 doctors surveyed here have officially opted out of the Medicare system altogether. Patients on Medicare who choose to see them must pay the entire bill themselves.

The exodus appears to be placing a greater strain on the Anchorage Neighborhood Health Center, whose five doctors accept all walk-in Medicare patients. Since 2001, the number of Medicare patients there has more than doubled.

Other findings from the study:

• Nine out of 10 of Alaska's primary care physicians surveyed still participate in the Medicare system to some extent.

• Medicare patients don't appear to be using Alaska's hospital emergency rooms in greater numbers -- if figures at the Providence Alaska Medical Center emergency room that show no increase in patients 65 and older since 2004 are typical.

• Four out of five of the 51,000 Alaskans enrolled in Medicare in 2005 were 65 or older; one out of five of them (9,612 Alaskans) qualified due to disabilities.

• The 2009 increase in Medicare payments didn't persuade primary-care doctors to open their doors to significant numbers of new Medicare patients.

"But it's certainly possible that the increase -- spearheaded by Alaska's U.S. senators -- kept more doctors from turning away Medicare patients," the authors wrote.

Find George Bryson online at or call 257-4318.


George Bryson

George Bryson was a longtime writer and editor at the Anchorage Daily News.