Falling Medicare reimbursement crimps access. (Physicians Limit or Drop Medicare Patients).

The recent 5.4% decrease in Medicare reimbursement rates has started to take its toll on access to health care.

In Washington state, Medicare beneficiaries are finding it increasingly difficult to see a primary care physician or get a referral to a specialist. In a recent poll conducted by the Washington State Medical Association, 57% of physicians surveyed were either limiting Medicare patients or dropping all of their Medicare patients.

Of 194 medical practices representing 325 physicians statewide, almost half--88 practices--said they weren't raking new Medicare patients; 23 practices said they were dropping all Medicare patients, and 83 practices were making no changes. These statistics appeared in the association's report "Washington's Ailing Health Care System: Continued Decline, Guarded Prognosis."

"Increasingly, physicians are being forced to choose between keeping their medical practices financially viable and treating all of the Medicare patients that need their services," the report said.

Other state medical associations are reporting similar trends, though most of the accounts were anecdotal. "I don't think people are blurting it out on the street, but it's evident that physicians across the country are quietly telling their patients that they can't see them anymore because Medicare doesn't pay them enough," Jean Irwin, chief executive officer and administrator of Family Health Care Associates in Dallas/Fort Worth, told this newspaper.

Of the 57 primary care physicians who work for Family Health Care, 5 have recently opted out of Medicare.

The Wisconsin Medical Society predicted a Medicare pinch as early as February. The state has a higher percentage of Medicare beneficiaries and a lower ratio of participating physicians than the national average, and Wisconsin ...