NCPA - National Center for Policy Analysis

More Doctors Moving to Cash-Only Practices

October 4, 2012

Efforts by insurers to lower physician fees to make health care more affordable are achieving the opposite effect. In fact, many physicians are moving to a system where they no longer accept insurance and instead require upfront payments, says the New York Times.

  • A survey of 13,575 doctors by the Physicians Foundation found that in the next three years, 50 percent of primary care physicians plan to take steps that reduce patient access to their services.
  • Of those, 7 percent plan to switch to cash-only or concierge practices.
  • This is especially problematic considering the country is facing a shortage of primary care physicians -- by 2025 the nation will have 100,000 fewer doctors than needed.

As doctors stop taking regular insurance, patients are free to take their business elsewhere. More insurance plans are beginning to cover out-of-network expenses. However, patients only get reimbursed for a fraction of their out-of-pocket expenses. Furthermore, making out-of-pocket expenses deters people from going to see their doctor for preventative treatment, instead waiting until they get sick.

Experts advise a few precautions when dealing with a physician that doesn't accept insurance:

  • Understand how much reimbursement you receive for out-of-network coverage.
  • Try to estimate your out-of-pocket costs in advance so you can pay the physician with money saved in a flexible spending account, which is sheltered from taxes.

As more doctors begin to decline insurance, many wonder whether the Affordable Care Act can succeed by expanding insurance to more Americans if primary care doctors are walking away from insurance.

Source: Roni Caryn Rabin, "When Doctors Stop Taking Insurance," New York Times, October 1, 2012.


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