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Medicaid patients increasingly concentrated among physicians
Abstract:
Despite increases in Medicaid payment rates and enrollment, the proportion of U.S. physicians accepting Medicaid patients has decreased slightly over the past decade, according to a national study by the Center for Studying Health System Change (HSC). In 2004-05, 14.6 percent of physicians reported that they received no revenue from Medicaid, an increase from 12.9 percent in 1996-97. There were also small increases in the percentage of physicians who were not accepting new Medicaid patients. A more striking trend is that care of Medicaid patients is becoming increasingly concentrated among a smaller proportion of physicians who tend to practice in large groups, hospitals, academic medical centers and community health centers. Relatively low payment rates and high administrative costs are likely contributing to decreased involvement with Medicaid among physicians in solo and small group practices.
Insights
Despite higher Medicaid payment rates, fewer U.S. physicians accept Medicaid patients. Care is concentrating among fewer doctors, particularly in large practices, due to low reimbursement and high administrative burdens.
Area of Science:
- Health Services Research
- Physician Practice Patterns
- Medicaid Policy
Background:
- Medicaid payment rates and enrollment have increased nationally.
- Physician participation in Medicaid is a key factor in patient access to care.
Purpose of the Study:
- To analyze trends in U.S. physician acceptance of Medicaid patients over the past decade.
- To identify factors influencing physician participation in Medicaid.
Main Methods:
- Analysis of national survey data on physician practice and payment.
- Comparison of physician acceptance rates between 1996-97 and 2004-05.
Main Results:
- The percentage of physicians receiving no Medicaid revenue increased from 12.9% to 14.6%.
- Physician care for Medicaid patients is concentrating in larger group practices, hospitals, and health centers.
- Low payment rates and high administrative costs are associated with reduced Medicaid participation, especially in solo/small practices.
Conclusions:
- Physician acceptance of Medicaid patients has declined despite policy changes.
- Care delivery for Medicaid beneficiaries is becoming increasingly concentrated, potentially impacting access.
- Addressing payment rates and administrative burden is crucial for improving physician participation.
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