NCPA - National Center for Policy Analysis


August 17, 2006

Many people who rely on government health insurance for the poor have to search harder to find a doctor and increasingly are going to large practices, a study shows.

Officials say Medicaid's reimbursement rate is the biggest reason that it is getting more difficult to locate doctors who take new patients under the program.  On average, reimbursements are 69 percent of what Medicare pays and even lower compared with what private insurers pay.

Doctors frequently complain about the administrative hassles.  For example, physicians often have to get approval before prescribing medicine or conducting tests.

  • Overall, the percentage of physicians not accepting new Medicaid patients has risen from about 19.5 in the mid-1990s to about 21 over the past few years; the change was much more pronounced among solo and small group practices.
  • It is not clear whether the trend has prevented Medicaid participants from getting medical care, but the potential is there if it continues, say the study's authors.

"Many of the large Medicaid providers are located in areas where enrollees tend to live, such as inner cities and medically underserved areas," according to the Center for Studying Health System Change, which conducted the study.

The center compared telephone surveys that it periodically conducts with doctors to reach its findings.  It compared the survey from 1996-97 with one from 2004-05.

  • In the earlier survey, 29 percent of solo physicians reported no new Medicaid patients.
  • Nearly a decade later, 35.3 percent of solo physicians reported accepting no new Medicaid patients.
  • A similar trend was found in small group practices (consisting of up to nine doctors) where the percentage of doctors not accepting Medicaid patients grew from 16.2 to 24 percent.

Source:  Kevin Freking, "Doctors taking less Medicaid patients," Seattle Post-Intelligencer, August 17, 2006; based upon: Peter J. Cunningham and Jessica H. May, "Medicaid Patients Increasingly Concentrated Among Physicians," Center for Studying Health System Change, Tracking Report No. 16

August 2006.

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