Analysis: The Vast Majority of Physicians
Accept New Patients, Including Patients With Medicare and Private
Insurance
Despite occasional
anecdotal reports of people having trouble finding a doctor who takes
their insurance, KFF researchers find in a new
analysis that the vast majority of non-pediatric office-based
physicians accept new Medicare patients, as well as new private insurance
patients.
Eighty-nine percent of
such physicians accepted new Medicare patients in 2019, and 91 percent
accepted new private insurance patients, according to the analysis, which
uses data from the federal 2019 National Electronic Health Records Survey
(NEHRS). Among primary care physicians the rates are lower, but still
comparable for new patients with Medicare (83%) and private insurance
(86%).
In addition, the
analysis found that roughly the same percentage of non-pediatric
office-based physicians accepted new Medicare patients in 2011 (88%) as
in 2019. And the share of physicians who accept new private insurance
patients has risen considerably over the period -- up 10 percentage
points from 81 percent in 2011 to 91 percent in 2019.
The new analysis also
contains state-level data. KFF researchers find that in 23 states, at
least 90 percent of all non-pediatric office-based physicians accepted
new Medicare patients in 2015-2017. Across all states the share ranged
from 76 percent in Washington D.C. to 95 percent in three states (Iowa,
Minnesota, and Pennsylvania), similar to the range for privately-insured
patients.
The findings are notable
because some proponents of doing more to contain health care costs have
proposed adopting Medicare rates, or a multiple of Medicare rates, for
those who now have private insurance, since Medicare rates tend to be
lower. Skeptics of that approach – which could involve directly
regulating prices, or creating a Medicare-like plan as a public option or
as part of a single payer system -- have raised concerns that moving
towards Medicare rates would cause access problems.
Across a range of specialties, KFF analysts find that the share of
physicians accepting new Medicare patients is similar to the share
accepting new patients with private insurance. The share of physicians
accepting new patients is lowest among psychiatrists, with 60 percent
accepting new Medicare patients and 59 percent accepting new
privately-insured patients.
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