One concern regularly raised about reductions in Medicare payments to doctors is that it might lessen access to care for beneficiaries by encouraging physicians to stop seeing new Medicare patients or even any Medicare patients at all. That has been a primary motivation for Congress’ continual overriding of the Sustainable Growth Rate formula cuts that would have kicked in over the last several years. The Kaiser Family Foundation examines the issue of beneficiary access to physician services. (KFF Brief) Almost all Medicare beneficiaries, 96%, say they have a usual source of care, most often a doctor’s office or clinic. About 51% of beneficiaries say they can get an appointment within three days and only 12% say they have to wait longer than 19 days. Fee-for-service and Medicare Advantage beneficiaries report similar rates of being able to schedule a timely appointment, with specialists slightly easier to find appointments with than primary care physicians. Access for beneficiaries on these measures is as good or better than that for under-65 adults. There is some geographic variation with Oregon having the highest rates of access to timely primary care appointments and New Mexico the lowest, while Nebraska has the highest rates for specialty care and New Mexico is the lowest there as well. Almost all Medicare beneficiaries can find a new doctor when they want one. And only a small percentage report foregoing medical care in the past year, but access to a doctor is not usually the reason. Most office-based physicians, 91%, are accepting new Medicare patients. The only specialty with notably low participation rates are psychiatrists, with only 64% saying they take new beneficiaries on. This could become an issue as rates of dementia, depression and other mental illness continue to grow among the Medicare population. Geographically, only 79% of doctors in Oregon take new Medicare patients, while 98% do in Florida. Most beneficiaries live in a state where at least 90% of physicians are accepting new beneficiaries. Very, very few physicians have completely opted out of Medicare. For now, there appears to be adequate physician access and the growth in use of nurse practitioners and physician assistants would likely ameliorate any significant change in doctor access in the future.
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
Cano Health apparently cannot, as it declares bankruptcy due to too much debt. Building primary care centers to serve Medicare, Medicaid and commercial populations, which is Cano’s business, was hot...
February 6, 2024
Turquoise health raises a fresh $30 million in capital for its price transparency platform, as the market for funding health care companies isn’t quite dead yet.
January 24, 2024
I am co-f0under of a company that manages cell and gene therapy for health plans. Cell therapy has made a big difference for many cancer patients but like all new...
January 24, 2024
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace