Medicaid Patients Have Harder Time Finding a New Physician

Physicians were accepting nearly equal amounts of new Medicare and privately insured patients in 2013, but much fewer were accepting new Medicaid patients, according to a new report from the CDC’s National Center for Health Statistics using the 2013 National Electronic Health Records Survey (NEHRS).

The researchers found a strong correlation between payment rates and acceptance of new Medicaid patients—in states with lower Medicaid payment rates, fewer physicians were accepting new Medicaid patients. However, the Affordable Care Act has called for Medicaid payments for some services to be equal to Medicare rates.

“This payment change is expected to greatly increase Medicaid payment rates in some states where rates were well below Medicare rates,” the researchers wrote. “However, many states experienced delays in implementing payment increases, which meant that most states had not implemented the payment increases by the time NEHRS was fielded in early 2013.”

Overall, 95.3% of physicians were accepting new patients in 2013 with 84.7% accepting new privately insured patients, 83.7% accepting new Medicare patients and only 68.9% accepting new Medicaid patients.

In addition, physicians within metropolitan areas were less likely to accept new Medicaid and Medicare physicians compared with physicians outside of these areas. Within metropolitan areas 82.9% and 67.2% of physicians were accepting new Medicare and Medicaid patients, respectively, compared with 91.2% and 85.7% of physicians accepting new Medicare and Medicaid patients, respectively, outside of metropolitan areas.

There were large variations in acceptance rates of new patients state by state, according to the data. For instance, in the District of Columbia, only 67.1% of physicians were accepting new privately insured patients in 2013 compared with 95.1% in Illinois. Eight states had physicians accepting new privately insured patients at a significantly higher rate than the national average: Arkansas (91.9%), Illinois (95.1%), Minnesota (94.9%), Nebraska (91.3%), New Hampshire (91.8%), Oklahoma (94.1%), West Virginia (91.9%), and Wyoming (91.5%).

North Dakota physicians had the highest acceptance rate of new Medicare patients (95.2%), followed by Minnesota (94.1%), Nebraska (93%), and South Dakota (92.2%). When compared to the national average (83.7%), no state had a significantly lower percentage of physicians accepting new Medicare patients.

The situation for Medicaid patients was very different. Half the country (25 states) was accepting new Medicaid patients at a rate that was significantly her than the national average (68.9%). Nebraska had the highest acceptance rate in the country at 96.5%. These high acceptance rates were offset by very low acceptance rates in 5 states: California (54.2%), Florida (55.9%), Louisiana (56.8%), New Jersey (38.7%), and New York (57.1%).