6 Key Statistics on Medicare Beneficiaries' Access to Physicians

A recent Kaiser Family Foundation issue brief found most Medicare patients have good access to physicians on a national level.

The possibility of significant Medicare reimbursement cuts for physicians due to the program's sustainable growth rate has fueled concerns that practitioners will stop seeing Medicare patients. House lawmakers recently introduced legislation to shield physicians from a scheduled 24 percent Medicare reimbursement reduction until next March, giving Congress more time to enact a permanent fi x by repealing and replacing the SGR. Every year since 2003, Congress has temporarily bypassed the SGR so physicians would not have to endure double-digit cuts to their Medicare pay.

However, on a national level, Medicare patients have good access to physicians, according to a Kaiser Family Foundation issue brief.

Kaiser researchers analyzed the Medicare Current Beneficiary Survey and found 96 percent of beneficiaries report having a usual source of care. Of those patients, 86 percent say their primary source is either a physician's office or a physician's clinic.

"Access to physicians for Medicare patients is not a widespread problem," says Cristina Boccuti, a senior associate with the Kaiser Family Foundation and co-author of the issue brief. "Some more vulnerable or disadvantaged patients are at a higher risk. Still, among these vulnerable patients, the majority report good access."

Certain subgroups of beneficiaries are more likely than the general Medicare population to lack a usual care source. For instance, 11.5 percent of Medicare beneficiaries without any supplemental coverage such as Medigap or Medicaid report not having a usual source of care. Other higher-risk demographics include Hispanic beneficiaries, those with lower incomes and those younger than 65 with a permanent disability.

Here are five more key findings from the issue brief.

1. Medicare beneficiaries appear to usually or always be able to schedule timely appointments with physicians. Fifty-one percent report they were able to get appointments within three days. Regarding specialist appointments, 92 percent of traditional Medicare beneficiaries and 90 percent of Medicare Advantage patients say it's "always" or "usually" easy to get an appointment.

2. The 2012 MedPAC patient survey found only 7 percent of Medicare beneficiaries reported looking for a new primary care physician.

3. The 2011 National Health Interview Survey found only 2.4 percent of Medicare seniors had trouble finding a general physician or provider that year, compared with 1.7 percent of privately insured adults aged 18 to 64.

4. According to physician survey data, 91 percent of non-pediatric physicians accept new Medicare patients, on par with the rate that accept new patients with private noncapitated insurance.

5. Less than 1 percent of physicians in clinical practice have formally opted out of Medicare. Of those who have, 42 percent are psychiatrists.

Despite the current good level of physician access for Medicare beneficiaries, the steadily increasing Medicare population and expected increase in newly insured younger adults as a result of the Patient Protection and Affordable Care Act necessitate ongoing efforts to monitor access issues, according to the issue brief.

Additionally, the Kaiser Family Foundation's Ms. Boccuti says there's a need to focus on smaller geographic areas to get a better idea of local access issues.

"We need to look more carefully at smaller, local market areas that may be having problems with both Medicare and other insurers," she says.

More Articles on Medicare Beneficiaries:
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Study: Hospital Observation Doubled Between 2001 and 2009 

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