By Paula Span July 6, 2011 11:58 am July 6, 2011 11:58 am
A few years back, a spate of news reports and medical journal articles reporting that doctors were refusing to accept Medicare patients caught the attention of Dr. Tara Bishop, an internist and assistant professor of public health at Weill Cornell Medical College in New York. The articles, including one in The New York Times. blamed low reimbursement rates and burdensome paperwork requirements.
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She wondered if it was true. Were significant numbers of doctors bailing out of Medicare, the nation’s largest health insurer?
Dr. Bishop and two colleagues tried to answer the question by analyzing data from a National Center for Health Statistics survey of 4,112 physicians practicing in private, nonhospital offices and accepting new patients from 2005 to 2008. They’ve just published their findings in the Archives of Internal Medicine.
“There was a small decline in Medicare acceptance, but it wasn’t very dramatic,” Dr. Bishop told me in an interview. “Well over 90 percent of doctors, in all kinds of specialties, still take new Medicare patients.”
The numbers: 95.5 percent of physicians said they accepted new Medicare patients in 2005. a proportion that fell to 92.9 percent in 2008. The declines were actually greater for patients with traditional fee-for-service health insurance (from about 97 percent acceptance to just under 90 percent) and, not surprisingly,
for Medicaid patients. Medicaid has always reimbursed at lower rates, and by 2008 only two-thirds of doctors would take on new Medicaid patients.
But for Medicare, difficulties in finding a doctor may have been exaggerated. In March, the annual report to Congress by the independent Medicare Payment Advisory Commission reached similar conclusions, based on patient surveys, though it noted that a small proportion have trouble when they seek a new primary care physician. Medicare beneficiaries, the commission reported, have fewer access complaints than 50- to 64-year-olds with private insurance.
Dr. Bishop acknowledged that access problems might be greater in certain geographic areas and that doctors might accept Medicare patients only in limited numbers. But I expect many of you feel the obstacles are still greater. If you’ve had trouble finding a doctor to accept Medicare, for yourself or for an older relative, I’d like to hear about your experience in the comments section.
When Dr. Bishop and her colleagues look at subsequent surveys — it takes about two years for the N.C.H.S. to publish data, so the 2009 results just emerged — they’ll try for a more detailed picture. “We’re hoping to look at more specific regions and pockets to see if there are places where it’s more of a problem,” she said.
Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”