Medicare Beneficiaries Access to Physicians

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.