About 97% of Los Angeles Primary Care doctors accept new Medicare patients. It’s only 35% in Portland OR.
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Around here large hospital operators are buying up Primary Care clinics and then telling Medicare patients that they must be on Medicare Advantage if they want to continue to see their doctor.
I’ve changed doctors twice in the last 5 years due to Corporate buyouts.
This why I believe Luigi will never be convicted by a jury.
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Anybody have an explanation for that?
One obvious factor……the prohibitive overheads of operating small scale businesses. Dentistry and vet medicine are the same. For primary care particularly and Medicare rebursement, the fee for any non procedures based visit barely covers the overheads generated before a person gets to sit down in the reception area (hint: it begins the moment as person leaves the public highway….whether walking across or parking in a well maintained parking lot)
Edit: it’s the lucky practitioner who has quick thinking, street smart front desk staff who know where next week’s paycheck comes from (or not, if they don’t get their hands on any appropriate payment device)
They’re driving more cost to the patient. The bonkers thing is that MA plans often pay doctors less than traditional Medicare. It’s a win, lose, lose scenario. Guess who’s winning.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2643349#
@eldemonio…..only when a patient requires “care” (which I’m going to define as any provider -patient interaction)
MA plans operate on a sort of modified capitation system. A practice is paid an overall fee for having a patient on their books….and the hope/expectation is that all that patient’s need can be catered to and still have $$$bucks in the War Chest at the end of the month. Better yet, have a patient in rude good health who you never have to hear from, and whose MA fee can then continue to pay the ongoing costs generated by the frequent flyers in the practice……because the most loyal employee doesn’t stay loyal for long when paychecks start bouncing.
As another edit…..MA plan operators are doing their part to keep the sick and expensive to treat patients out of these primary care settings.
Whilst I cannot speak from personal experience (manifestly I’m not credulous enough to fall for MA marketing bamboozle) I understand that the less scrupulous of these put barriers in the way of folk with complex conditions even being eligible for the plans in the first place.
I mentioned in another thread that I perceive primary care providers as devolving into glorified box checkers rather that problem solvers….you can see why. Cannot generate an income by pondering the peculiarities of outliers.
If only primary care providers could operate like divorce lawyers. We just got the invoice that has taken us (“us” being husband and me….and not even including daughter and the business) over the $1mill mark. Just over 2 years since we coughed up the first $20k retainer thinking that was a hefty amount 
I ain’t puzzled by the leaching “Medical Insurance” rackets, but puzzled that Portland sucks and Los Angeles doesn’t. Is the difference in complications of corruption in legislatures of California and Oregon?
There is some misinformation here that many doctors won’t take traditional medicare. Most will.
Google AI
Sources
KFF
Doctors are not limited to Medicare Advantage; however, many only accept that, or only accept Original Medicare, creating fragmented access. While 99% of physicians accept Traditional Medicare, only 46% of those in network for Medicare Advantage accept those plans. Some providers opt out of Medicare entirely, or limit new patient intake.
Key Takeaways on Provider Participation:
[image]Medicare (.gov) +5
I think it’s dependent on the ratio of Private Equity operators (i.e., market concentration) and the Medicare Advantage uptake. Lack of antitrust enforcement is killing us.
From the research paper:
{{ Notably, Portland had the highest primary care physician supply (116.3 per 100,000), the
most concentrated hospital market (HHI=2,580), greater1consolidation in primary care delivery, and the highest Medicare Advantage penetration (67.1%). }}
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