NCPA - National Center for Policy Analysis

Seniors' Access To Medicare Physicians Falling

September 25, 2002

The Balanced Budget Act of 1997 made substantial changes to Medicare payment for specialists. The 5.4 percent cut in Medicare physician payments for 2002 has raised concerns that Medicare beneficiaries will face serious problems obtaining needed physician services. Congress is considering legislation to prevent significant deterioration in access to care for Medicare beneficiaries, but experts say that factors outside of Medicare have led to poorer access for all patients and may continue to do so even if future Medicare cuts are cancelled.

Three key measures of access are whether patients delayed or did not obtain needed care, whether patients could get a timely appointment with a physician and whether doctors are taking new patients. Based on these measures there is clear evidence that access problems are on the rise, say researchers.

  • In 2001, 11 percent of Medicare seniors experienced delays or were "put off" by a provider when seeking an appointment -- up from 9.1 percent in 1997.
  • Of these, 23.6 percent could not obtain a timely appointment while 11.3 percent couldn't get through on the phone.
  • These figures for 2001 were 70 percent and 60 percent higher (respectively) than 1997.

Experts note that Medicare physician payment policy often has been driven by congressional efforts to reduce the federal budget deficit, constrained by concerns about access and physician representatives' pleas for fairness.

Source: Sally Trude and Paul B. Ginsburg, "Growing Physician Access Problems Complicate Medicare Payment Debate," Issue Brief No. 55, September 2002, Center for Studying Health System Change.

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