Dr. Timothy Kresowik The Iowa Medical Society may go to court to challenge the federal payment levels for the elderly Medicare patients who’re treated in Iowa hospitals and clinics. Iowa has one of the lowest Medicare reimbursement rates in the country meaning, for example, that physicians in larger states get paid more for providing the same kind of care.

Dr. Timothy Kresowik of Iowa City, chairman of the Iowa Medical Society’s board of directors, says since congress has failed to adjust the payment formula, it may be time to sue. "Iowa Medical Society is actually looking at a judicial remedy, whether we would in fact file a lawsuit against the Medicare program because it’s clearly not right," Kresowik says.

According to Kresowik, some patients in rural parts of the state are getting substandard care, too, because of the funding inequity. He says clinics and hospitals in smaller Iowa communities cannot afford doctors in certain specialty areas, like neurology. "Neurologists would be the people that provide stroke care," Kresowik says. "Many of these communities are having trouble attracting and retaining those kind of individuals that would be there to provide for acute stroke care, so it becomes a true accessibility issue just because you live three hours away from where there is a facility that could treat that stroke, your outcomes are going to be worse."

Kresowik, a surgeon at the University of Iowa Hospitals and Clinics, spoke this morning at a roundtable discussion on health care held at Des Moines University. U.S. Senator Tom Harkin and Congressman Leonard Boswell both attended the event, admitting it’s unlikely congress will vote to adjust the funding formula for reimbursing doctors, hospitals and others who provide medical care to elderly Medicare patients.