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Media reports over the past several years have suggested that Medicare beneficiaries have trouble finding doctors who will accept their insurance.[1] The perceived threat of a Medicare provider shortage has been used to advocate for a slew of damaging legislation, including, among others proposals, allowing Medicare physicians to "balance bill" beneficiaries (charge them more than the Medicare approved amount).

However, according to an issue brief recently released by the Kaiser Family Foundation, reports of a Medicare provider shortage are unfounded. The brief found that in most cases people with Medicare have comparable or better access to doctors than privately insured individuals.

The report found that:

  • On a national level, Medicare patients have good access to physicians.  The vast majority (96%) of Medicare beneficiaries report having a usual source of care, primarily a doctor’s office or doctor’s clinic.
  • Most people with Medicare — about 90% — are able to schedule timely appointments for routine and specialty care. Medicare seniors are more likely than privately insured adults age 50-64 to report "never" having to wait longer than they want for timely routine care appointments.
  • A small share of Medicare beneficiaries say they looked for a new physician in the past year, and only 2% of seniors with Medicare report problems finding one when needed — comparable to rates reported by privately insured adults age 50-64.
  • Medicare seniors report foregoing medical care at similar or lower rates than privately insured adults age 50-64. Certain subgroups of the Medicare population are more likely than others to report not seeing a doctor when they thought they needed to during the year, particularly beneficiaries who: are under age 65 and qualify for Medicare because of a permanent disability; have either Medicaid (dually eligible for Medicare and Medicaid) or no supplemental coverage; are Black; have lower incomes; are in fair or poor health, and/or have five or more chronic conditions.  Even within these vulnerable subgroups, however, the majority do not report foregoing doctor visits when needed.
  • According to recently-released physician survey data, the majority (91%) of non-pediatric physicians accept new Medicare patients—the same rate that accept new patients with private non-capitated insurance.  This correlation persists generally across states, indicating that physician acceptance of new Medicare patients may be more related to local market factors than issues unique to Medicare overall.
  • According to new physician data from Medicare, less than 1% of physicians in clinical practice have formally "opted-out" of the Medicare program, with psychiatrists accounting for the largest share (42%).

To read the full report, visit http://kff.org/medicare/issue-brief/medicare-patients-access-to-physicians-a-synthesis-of-the-evidence/.

 


[1] The NY Times, Doctors are Opting Out of Medicare,  April 1, 2009 http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html?_r=0; The NY Times, Walking Away from Medicare, June 26, 2013 http://newoldage.blogs.nytimes.com/2013/06/26/walking-away-from-medicare/The Wall Street Journal, More Doctors Steer Clear of Medicare, (July 29, 2013) http://online.wsj.com/news/articles/SB10001424127887323971204578626151017241898

 

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