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Doctors More Willing To See Medicare Patients Than Privately Insured

U.S. physicians were less willing to treat privately insured patients than Medicare beneficiaries from 2005 to 2008, according to a study published in the Archives of Internal Medicine, Bloomberg reports.

Key Findings

The study found that the percentage of physicians who were willing to accept privately insured patients decreased from 93% in 2005 to about 88% in 2008. Meanwhile, the physicians accepted about 93% of Medicare beneficiaries in 2008, down from 96% in 2005, according to the study.

The study also found:

  • 57% of U.S. residents under the age of 65 had employer-sponsored health insurance in 2009, while 20% received coverage through Medicaid or other public insurance plans; and
  • Medicaid beneficiaries had the most difficulty finding a doctor willing to accept their coverage (Armstrong, Bloomberg, 6/27).

Reaction to Findings

The study authors said the greater decline in physicians accepting private insurance was "unexpected."

Lead author Tara Bishop, an internist and assistant professor of public health at Weill Cornell Medical College, said some physicians might be trying to avoid administrative hassles associated with treating privately insured patients. She also said that while Medicare might not always pay the most for patient care, it is at least a reliable payer (Hensley, "Shots," NPR, 6/27). She noted that some private health plans are low payers, causing physicians to avoid them.

Robert Zirkelbach, spokesperson for America's Health Insurance Plans, said doctors are accepting fewer patients because certain insurers have limited the network of physicians and hospitals with whom they contract in order to address concerns related to quality and value.

Effect of Health Reform

Leighton Ku, professor of health policy at George Washington University, said the findings are troubling because the federal health reform law calls for an expansion of insurance coverage, meaning that more people will be trying to see physicians who are unwilling to take certain patients.

Ku said, "If you see a big surge in demand in 2014 and not enough doctors taking patients, then we have a recipe for a bad situation."

Bishop said, "At a moment when the country is poised to achieve near-universal coverage, patients' access to care could be a casualty of the collision between the medical profession and the insurance industry" (Bloomberg, 6/27).

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