New MedPAC physician member offers a rural perspective

Preserving Medicare's financial viability is especially important for rural doctors and hospitals because of their big beneficiary caseloads, Dr. Dean says.

By David Glendinning, AMNews staff. June 25, 2007.

Washington -- The Medicare Payment Advisory Commission last month welcomed another physician to the panel. Thomas M. Dean, MD, a board-certified family physician who has practiced in South Dakota for nearly 30 years, says he brings a much-needed rural viewpoint to the body.

The appointment of Dr. Dean, 62, chief of staff at Avera Weskota Memorial Medical Center in Wessington Springs, to a three-year term brings the number of doctors on the panel to six. The group of 17 MedPAC members makes recommendations to Congress on how to set Medicare reimbursement rates. Commission reports often form the starting point for legislation affecting doctors.

AMNews recently spoke with Dr. Dean about his appointment.

Why were you nominated?

I was officially nominated by the National Rural Health Assn. The main reason was that there has been a shortage of rural representation on MedPAC. The authorizing legislation specifies that there should be a balance between rural and urban interests, and the last few years there has really only been one individual out of the 17 that really was tuned into some of the unique rural needs.

What are some of the conditions facing the rural health care system that you hope to bring to the forefront?

The most underlying concern, which isn't uniquely rural, is a real concern about the long-term financial viability of Medicare. We simply have to make the program stable financially. It's terribly important for the whole nation, but even more so for rural areas, because we have a higher proportion of elderly and disabled folks than the urban areas. It's the biggest source of income for many rural hospitals. In our own little hospital here, our utilization runs around 80% to 85% Medicare.