Advertisement

 

 

Rejection of Medicare & Private Coverage "Overstated"

Rejection of Medicare & Private Coverage "Overstated"
Advertisement

Several recent news articles from the media have discussed a drop in the number of physicians who accept patients with Medicare. However, recent trends in acceptance of various insurance types have not been examined, according to an analysis published in the June 27, 2011 Archives of Internal Medicine.

Using data from a national survey, three doctors examined trends in physician acceptance of several insurance types, as well as self-pay patients. Their hope was that understanding “these trends can help informpolicymakers of potential access problems, particularly giventhe shortages in primary care, an aging population, growingprevalence of chronic disease, and insurance expansion underthe Patient Protection and Affordable Care Act.”

Looking at data from 2005 to 2008, researchers found only a 2.6% reduction in the number of physicians who accepted patients with Medicare. The decline in acceptance was seen mostly among physicians in private practice. By contrast, physician acceptance of patients with private, non-capitated insurance had a more pronounced decline, dipping from 93.3% in 2005 to 87.8% in 2008. Acceptance of self-paying patients did not change significantly over the study period. Acceptance among both the above groups was still higher than that for patients with Medicaid and private, capitated capped insurance; a decline was seen over the study period among both latter groups.

Based on their finding that more than 90% of physicians still accept Medicare patients despite marginal increases in reimbursement, the research team suggested that “anecdotal reports may be overstating access problems.” They noted that the decline in acceptance of private, non-capitated insurance was unexpected and suggested that it may be related to reimbursement and administrative burden. Lower reimbursement may also be behind the lower acceptance rates of capitated insurance. Due to historically poor reimbursement rates, the study team was not surprised by the low and declining acceptance of new Medicaid patients.

Physician’s Weekly wants to know…

  • Have you stopped accepting any group of patients based on their insurance type?
  • Do you agree with the authors that anecdotal reports may be overstating trends in declining acceptance of Medicare patients?
  • How is your insurance acceptance affected by the impending expansion of health insurance coverage in the United States?

Submit a Comment

Your email address will not be published. Required fields are marked *

4 × 2 =

[ HIDE/SHOW ]