In 2011 nearly one-third of physicians said they would not accept new Medicaid patients, but rising fees may help

Abstract

When fully implemented, the Affordable Care Act will expand the number of people with health insurance. This raises questions about the capacity of the health care workforce to meet increased demand. I used data on office-based physicians from the 2011 National Ambulatory Medical Care Survey Electronic Medical Records Supplement to summarize the percentage of physicians currently accepting any new patients. Although 96 percent of physicians accepted new patients in 2011, rates varied by payment source: 31 percent of physicians were unwilling to accept any new Medicaid patients; 17 percent would not accept new Medicare patients; and 18 percent of physicians would not accept new privately insured patients. Physicians in smaller practices and those in metropolitan areas were less likely than others to accept new Medicaid patients. Higher state Medicaid-to-Medicare fee ratios were correlated with greater acceptance of new Medicaid patients. The findings serve as a useful baseline from which to measure the anticipated impact of Affordable Care Act provisions that could boost Medicaid payment rates to primary care physicians in some states while increasing the number of people with health care coverage.

Exhibit 4. Percentage Of US Office-Based Physicians Accepting New Medicaid Patients In 2011 And The Medicaid-To-Medicare Fee Ratio

sources National Ambulatory Medical Care Survey Electronic Medical Records Supplement, 2011; and Note 17 in text. NOTES The line pictured is from an ordinary least squares regression of the percentage of US office-based physicians accepting new patients, by state, on the fee ratio. Data points represent all fifty states and Washington, D.C., but only selected points are labeled.