The Medicare program gives most beneficiaries ample access to physician services, as 91 percent of office-based doctors accept new Medicare patients and few physicians in clinical practice have left Medicare, according to a new study by the Henry J. Kaiser Foundation.
The study, based on national patient and physician surveys and government data, found 96 percent of beneficiaries reported regular access to a doctor's office or clinic. And 90 percent of patients surveyed could book prompt appointments for routine and specialty care.
While most respondents said they could find a new doctor when necessary, 2 percent of seniors encountered problems finding one in the past year. Most respondents reported forgoing medical care at similar or lower rates than privately insured Americans ages 50 to 54.
However, vulnerable segments of the Medicare population are more apt than others to have physician access problems. These subgroups include the permanently disabled, dual-eligible (Medicare and Medicaid) patients, beneficiaries without supplemental coverage, people who are black or have lower incomes, and people with five or more chronic medical conditions. But even within these subgroups, most Medicare beneficiaries did not skip doctor's visits when necessary, the study found.
These findings come amid sweeping program changes affecting practitioners and insurers: Medicare reimbursement to physicians will get cut by nearly 24 percent on Jan. 1 unless Congress intervenes. Health insurers, supported by AHIP, are trying to thin their provider networks in response to program payment reductions. Although a federal judge recently barred UnitedHealthcare from dropping about 19 percent of doctors from its Medicare Advantage network in Connecticut, the country's largest insurer is going ahead with plans to narrow the network.
And congressional committees are considering legislation to repeal Medicare's longstanding physician payment formula and replace it with new payment models emphasizing quality of care as opposed to patient and procedure volumes, according to the Kaiser Foundation.
But in all states, most practicing physicians accept new Medicare patients, and 58 percent of Medicare beneficiaries live in states where at least 90 percent of the doctors have open practices. And only 1 percent of doctors in clinical practice nationwide have formally opted out of Medicare, the study showed.
- see the study results