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HHS: More doctors accept new patients with Medicare than private coverage

CMS official: New report offers a 'more complete picture' of Medicare providers

Topics: Medicare, Reimbursement, Finance, Physician Issues

August 22, 2013

The number of physicians accepting new Medicare beneficiaries increased by one-third between 2007 and 2011 and now surpasses the number of doctors accepting new patients with private insurance, according to a report from the HHS's Office of the Assistant Secretary for Planning and Evaluation.

The report was obtained ahead of publication by USA Today.

According to the report, 1.25 million physicians submitted claims for Medicare reimbursements in 2011, up from 925,000 in 2007. The report also found that 90% of office-based physicians accept new Medicare beneficiaries, nearly mirroring the number of doctors who accepted privately insured patients.

HHS commissioned the report in response to a Wall Street Journal article last month, which cited CMS data suggesting that the number of physicians who have "opted out" of Medicare has nearly tripled from 3,700 in 2009 to around 9,500 in 2012. HHS officials argue that these "opt outs" will not cause problems for Medicare beneficiaries because more primary care physicians (PCPs) are entering the system than older physicians who are dropping out.

"I think the [new HHS] report comes at a time when people are asking questions about Medicare," said CMS's Jonathan Blum, adding, "It provides a more complete picture of how physicians choose to participate in the Medicare system."

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Concern about Medicare payments mounts

According to USA Today, many Medicare physicians have expressed concern about payment caps in Medicare and new paperwork requirements.

In addition, Joe Baker—president of the Medicare Rights Center—noted that while Congress continues to delay action on the sustainable growth rate formula, physicians increasingly are discussing insurance and Medicare reimbursement rates with their patients. Baker said, "They tell their patients, 'You should call your Congress person because if Congress cuts my reimbursement ... I won't be able to see you.'"

However, he said that while some of his organization's clients have faced some difficulty finding physicians in larger, densely populated cities, "there are still plenty of doctors taking Medicare." He added, "We've never not been able to find them a doctor that doesn't take Medicare" (Kennedy, USA Today, 8/22).

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