Physicians propose Medicare-only clinic

Doors to most doctors' offices may be closed to the thousands of new Medicare patients in Alaska each year, but a bold approach could open new access.

Southcentral Alaskans on Medicare who can't seem to gain entrée into a primary care doctor's office might have an alternative by the end of the summer, providing lawmakers sign off on a new nonprofit's $1 million request to get a clinic started in Anchorage.

That's looking likely. The proposal is backed by Sen. Kevin Meyer, R-Anchorage, and by House Finance Committee co-chairmen Reps. Bill Stoltze of Chugiach and Mike Hawker of Anchorage. It's also being lauded by Democrats, including Rep. Les Gara of Anchorage, who said this plan could solve a problem that's quickly turning into a crisis.

"We feel like our seniors have waited long enough -- it's time to take action," Meyer said at a press conference Friday unveiling the plans.

Medicare reimburses doctors at a rate that's less than they need to cover costs. That, along with a huge influx of older Americans seeking care under the federal program, has prompted doctors in urban Alaska to turn away new patients. The problem is worst among primary care providers and family practice doctors -- precisely the kind of professionals people have to start with in order to get referrals to higher levels of care and studies.

A group of doctors and others in the health care professions developed the concept for the Alaska Medicare Clinic, which would operate as a nonprofit seeing only patients covered by Medicare, or those eligible under Medicare and Medicaid. Using an approach that would have various levels of providers operating at their top levels, the group thinks efficiency can make Medicare work where it hasn't in other facilities.

"No one will admit a new Medicare patient in town," Dr. George Rhyneer said in an interview Friday. He was among a group of four doctors who developed the clinic plan to fix a broken government system. "It seems to be the only option out there for taking care of Medicare patients that's even remotely on the horizon, either locally or nationally.

"Hopefully this is not the kind of operation that necessarily has to go on forever -- but it certainly is the kind of operation we need at the present time because of the huge number of Medicare patients who just can't find a doctor."

Lawmakers put their weight behind the proposal as a small state investment that could enable a private-sector effort to eliminate some of the costs government ends up paying as Medicare patients are denied treatment early on, resulting in more expensive bills for emergency room care and hospitalization down the road.

The approach is all-new, developed by those who have spent time in the trenches.

A retired cardiologist, Rhyneer is a soft-spoken man, but there's no mistaking the urgency in his mission. Troubled by the rapidly increasing needs of Alaska's seniors who can't get in to see a doctor, he is optimistic this clinic could work, but didn't offer a sense of how much the state and hospitals could save.