Fewer Physicians Providing Charity Care, HSC Study Finds

Increased health care costs and reduced reimbursements have prompted a decreased number of physicians to provide charity care for the uninsured and accept Medicaid patients, trends that may reduce access to care for the two groups, according to a new study, the Hartford Courant reports (MacDonald, Hartford Courant, 12/5). In the study, researchers at the Center for Studying Health System Change analyzed the results of the Community Tracking Study Physician and Household Surveys, which interviewed about 12,000 physicians and 60,000 consumers. The study, titled "Mounting Pressures: Physicians Serving Medicaid Patients and the Uninsured," found that the rate of physicians who provide charity care decreased from 76.3% in 1997 to 71.5% in 2001. The rate of physicians whose practices accept Medicaid patients decreased from 87.1% to 85.4% over the same time period, the study found (HSC release, 12/3). The study attributed the trends to "financial pressures" on physicians, such as reduced reimbursements from HMOs, low Medicaid reimbursements and the increased cost of medical malpractice insurance (Hartford Courant, 12/5).

An HSC survey released in conjunction with the study found that the trends may have reduced access to care for some patients, the AP/Las Vegas Sun reports. The survey found that the rate of uninsured patients who said that they had visited a doctor in the past 12 months decreased from 51.5% in 1997 to 46.6% in 2001; the rate for Medicaid beneficiaries remained the same over the same time period (Meckler, AP/Las Vegas Sun, 12/5). Dr. Yank Coble, president of the American Medical Association, predicted that the decreases in the rates of physicians who provide charity care and treat Medicaid beneficiaries would continue in the future without an increase in reimbursements and a reduction in costs for physicians (Hartford Courant, 12/5). The HSC study is available online.