In 2011 Nearly One-Third Of Physicians Said They Would Not Accept New Medicaid Patients, But Rising Fees May Help
Open accessAbstract
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.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Most organizations have limited control over the financing strategies available to them, though they may engage in strategic decisions or negotiations about which they use.
“Most organizations have limited control over the financing strategies available to them, though they may engage in strategic decisions or negotiations about which they use [75, 76].”
From Translating economic evaluations into financing strategies for implementing evidence-based practices (2021) · cites this paper as [75]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Physician Participation in State Medicaid Programs
Sloan, F. A., Mitchell, J. B., & Cromwell, J. (1978) · The Journal of Human Resources · doi:10.2307/145253 · Cited by 245 · see citing works
Trends In Medicaid Physician Fees, 2003–2008
Zuckerman, S., Williams, A. F., & Stockley, K. (2009) · Health Affairs · doi:10.1377/hlthaff.28.3.w510 · Cited by 140 · see citing works
The States' Next Challenge — Securing Primary Care for Expanded Medicaid Populations
Ku, L. C., Jones, K., Shin, P., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmp1011623 · Cited by 102 · see citing works
Medicaid physician fees and the quality of medical care of Medicaid patients in the USA
Decker, S. L. (2007) · Review of Economics of the Household · doi:10.1007/s11150-007-9000-7 · Cited by 88 · see citing works
Self-citationChanges in Medicaid Physician Fees and Patterns of Ambulatory Care
Decker, S. L. (2009) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.5034/inquiryjrnl_46.03.291 · Cited by 78 · see citing works
Self-citationPatient Protection and Affordable Care Act: Promise and Peril for Primary Care
Goodson, J. D. (2010) · Annals of Internal Medicine · doi:10.7326/0003-4819-152-11-201006010-00249 · Cited by 75 · see citing works
PHYSICIANS' COST SHIFTING BEHAVIOR: MEDICAID VERSUS OTHER PATIENTS
Showalter, M. H. (1997) · Contemporary Economic Policy · doi:10.1111/j.1465-7287.1997.tb00467.x · Cited by 43 · see citing works
Medicaid physician fees and use of physician and hospital services.
Cohen, J. W. (1993) · PubMed · Cited by 37 · see citing works
Flagged first, then by citations
Research works printed but not linked: 13
- [1]Congressional Budget Office. CBO’s analysis of the major health care legislation enacted in March 2010. Washington (DC): CBO; 2011. March 30. [Google Scholar]
- [4]Centers for Disease Control and Prevention. QuickStats: percentage of office-based physicians accepting new patients, by type of payment accepted—United States, 1999–2000 and 2008–2009. MMWR Morb Mortal Wkly Rep. 2011;60(27):928. [Google Scholar]
- [5]Decker SL. The effect of physician reimbursement levels on the primary care of Medicaid patients. Review Econ Househ. 2011;5(1):95–112. [Google Scholar]
- [9]Decker SL. Medicaid physician fees and ambulatory care of Medicaid patients. Inquiry. 2009;46(3): 291–304. [DOI] [PubMed] [Google Scholar]
- [10]National Center for Health Statistics. National Ambulatory Medical Care Survey: Electronic Medical Records Supplement 2011 [Internet]. Hyattsville (MD): NCHS; [cited 2011. October 25]. Available from: from: http://www.cdc.gov/nchs/data/ahcd/2011_EMR_Survey.pdf [Google Scholar]
- [12]Resources Health and Administration Services. Area Resource File— 2009/2010. Rockville (MD): HRSA; 2009. [Google Scholar]
- [13]Kaiser Commission on Medicaid and the Uninsured. Medicaid enrollment: December 2010 data snapshot [Internet]. Washington (DC): The Commission; 2011 Dec [cited 2012. July 3]. (Medicaid Facts). Available from: http://www.kff.org/medicaid/upload/8050-04.pdf [Google Scholar]
- [14]Census Bureau. Resident population data [Internet]. Washington (DC): The Bureau; [cited 2012. July 3]. Available from: http://2010.census.gov/2010census/data/apportionment-pop-text.php [Google Scholar]
- [15]Kaiser Commission on Medicaid and the Uninsured. A profile of Medicaid managed care programs in 2010: findings from a 50-state survey. Washington (DC): The Commission; 2011. Sep. [Google Scholar]
- [16]American Medical Association. Physician characteristics and distribution in the U.S., 2011 [Internet].Chicago (IL): AMA; 2011. [cited 2012 July 3]. Available for purchase from: http://amascb.pdn.ipublishcentral.com/product/physiciancharacteristics-distribution-in-us-2011 [Google Scholar]
- [18]Goldberg EJ, Shimizu IM. Specifications for state level estimates for 2010 EMR Mail Survey. Hyattsville (MD): National Center for Health Statistics; 2011. September 29. Unpublished document. [Google Scholar]
- [19]Medicare Payment Advisory Commission. Report to the Congress: Medicare payment policy. Washington (DC): MedPAC: 2012. March. [Google Scholar]
- [20]Medicaid and CHIP Payment and Access Commission. Report to Congress on Medicaid and CHIP. Washington (DC): MACPAC;2010. Mar. [Google Scholar]
Cited by
Sorted by citations
Barnett, M. L., Boddupalli, D., Nundy, S., & Bates, D. W. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.0096 · Cited by 154 · see citing works
Barnett, M. L., Yee, H. F., Mehrotra, A., & Giboney, P. (2017) · Health Affairs · doi:10.1377/hlthaff.2016.1283 · Cited by 115 · see citing works
Gaps in well-child care attendance among primary care clinics serving low-income families
Wolf, E. R., Hochheimer, C. J., Sabo, R. T., DeVoe, J., Wasserman, R., Geissal, E., Opel, D. J., Warren, N., Puro, J., O’Neil, J., et al. (2018) · Pediatrics · doi:10.1542/peds.2017-4019 · Cited by 97 · see citing works
Translating economic evaluations into financing strategies for implementing evidence-based practices
Dopp, A. R., Kerns, S. E. U., Panattoni, L., Ringel, J. S., Eisenberg, D., Powell, B. J., Low, R., & Raghavan, R. (2021) · Implementation Science · doi:10.1186/s13012-021-01137-9 · Cited by 52 · see citing works
Luo, Z., Gritz, M., Connelly, L., Dolor, R. J., Phimphasone-Brady, P., Li, H., Fitzpatrick, L., Gales, M., Shah, N., & Holtrop, J. S. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-021-06596-w · Cited by 8 · see citing works
- Authors
- Decker, S. L.
- Affiliations
- National Center for Health Statistics (US)
- Corresponding author
- Decker, Sandra L.
- ORCID
- Decker, Sandra L.
- Venue
- Health Affairs
- Publisher
- Health Affairs Publishing, LLC
- Published
- 2012-08
- Volume
- 31
- Issue
- 8
- Pages
- 1673-1679
- ISSN
- 0278-2715 (ISSN-L)
- 1544-5208
- PMC
- PMC6292513
- OpenAlex
- W2135347028
- Cited by
- 360
- References
- 8
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 24 · 2023: 11 · 2022: 19 · 2021: 27 · 2020: 30 · 2019: 31 · 2018: 33 · 2017: 43 · 2016: 34 · 2015: 30 · 2014: 32 · 2013: 18 · 2012: 4
- FWCI
- 64.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Health Affairs (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
- Keywords
- Medicaid, Affordable Care Act, physician remuneration, Medicare, privately insured patients, primary care capacity, healthcare workforce, practice size, metropolitan areas, health insurance expansion
- MeSH terms
- Aged, Attitude of Health Personnel, Fees and Charges, Female, Health Services Accessibility, Humans, Male, Medicaid, Middle Aged, United States, Refusal to Treat, Health Care Surveys
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
