Acceptance of New Patients With Public and Private

NCHS Data Brief No. 195 March 2015

Acceptance of New Patients With Public and Private Insurance by Office-based Physicians: United States, 2013

Esther Hing, M.P.H.; Sandra L. Decker, Ph.D.; and Eric Jamoom, Ph.D., M.P.H., M.S.

Key findings

Data from the 2013 National Electronic Health Records Survey

In 2013, most office-based physicians (95.3%) were accepting new patients.

The percentage of physicians accepting new Medicaid patients (68.9%) was lower than the percentage accepting new Medicare (83.7%) or new privately insured (84.7%) patients.

The percentage of physicians accepting new Medicaid and Medicare patients was lower for physicians within metropolitan statistical areas (MSAs) compared with physicians outside of MSAs.

The percentage of physicians who accepted new privately insured, Medicare, and Medicaid patients each varied by state.

Physician acceptance of new Medicaid patients has shown to be lower than acceptance of new Medicare patients or new privately insured patients (1). Acceptance of new Medicaid patients also has shown to be lower in states with lower Medicaid payment rates to physicians (2). Using the 2013 National Electronic Health Records Survey (NEHRS), this report summarizes physician acceptance of new patients with Medicaid, Medicare, and private insurance. It also summarizes information on how these acceptance rates vary by select physician characteristics and by state.

Keywords: Medicaid ? Medicare ? National Electronic Health Records Survey

How did acceptance of new patients by office-based physicians vary by the patient's source of payment?

In 2013, 95.3% of physicians were accepting new patients (Figure 1).

The percentage of physicians accepting new privately insured patients (84.7%) was greater than the percentage accepting new Medicaid patients (68.9%).

Figure 1. Office-based physicians accepting new patients, by patient source of payment: United States, 2013

Accepts new patients

95.3

Private insurance1

84.7

Medicare1,2

83.7

Medicaid

68.9

0

20

40

60

80

100

Percent of physicians

1Difference from percentage accepting new Medicaid patients is statistically significant (p < 0.05). 2Excluding pediatricians, the percentage of physicians accepting new Medicare patients is 88.8%. SOURCE: CDC/NCHS, National Electronic Health Records Survey.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention

National Center for Health Statistics

NCHS Data Brief No. 195 March 2015

The percentage of physicians accepting new Medicare patients (83.7%) was also greater than the percentage accepting new Medicaid patients.

Did acceptance of new patients by office-based physicians differ by metropolitan status?

Within metropolitan statistical areas (MSAs), the percentage of physicians accepting new privately insured patients (84.6%) was greater than the percentage accepting new Medicaid patients (67.2%) (Figure 2).

The percentage of physicians accepting new Medicare patients was higher than the percentage accepting new Medicaid patients both within and outside of MSAs.

The percentage of physicians accepting new Medicare patients was lower within MSAs (82.9%) compared with those outside of MSAs (91.2%).

The percentage of physicians accepting new Medicaid patients (67.2%) was also lower within MSAs compared with those outside of them (85.7%).

Figure 2. Office-based physicians accepting new patients, by patient payment source and metropolitan status: United States, 2013

Percent of physicians

100

90

84.6

85.8

80

70

60

50

40

30

20

10

0 Private insurance1

91.2 82.9

Medicare2,3

MSA

Non-MSA

85.7

67.2

Medicaid3

1Within MSAs, the percentage of physicians accepting new privately insured patients is significantly greater than the percentage of physicians accepting new Medicaid patients (p < 0.05). 2Percentage of physicians accepting new Medicaid patients is lower than the percentage accepting new Medicare patients both inside and outside of MSAs (p < 0.05). 3Difference by metropolitan status is statistically significant (p < 0.05). NOTE: MSA is metropolitan statistical area. SOURCE: CDC/NCHS, National Electronic Health Records Survey.

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NCHS Data Brief No. 195 March 2015

Did acceptance of new privately insured patients by office-based physicians differ by state?

In 2013, the percentage of physicians who accepted new privately insured patients varied from 67.1% in the District of Columbia (DC) to 95.1% in Illinois (Figure 3).

In 2013, the percentage of physicians who accepted new privately insured patients was significantly higher than the national average (84.7%) in eight states (Arkansas, Illinois, Minnesota, Nebraska, New Hampshire, Oklahoma, West Virginia, and Wyoming).

In 2013, only DC had a significantly lower percentage of physicians accepting new privately insured patients (67.1%) compared with the national average.

Figure 3. Percentage of office-based physicians accepting new privately insured patients, by state: United States, 2013

WA 85.2

OR

84.0

ID

88.0

MT 85.8

WY 91.5

NV

84.3 UT

CA

85.8

76.6

CO 85.4

AZ 87.9

NM 90.8

AK

85.4

HI 75.0

NH 91.8

ND 87.8 SD 87.0

MN 94.9 WI

89.5

NE 91.3

KS 86.2

IA 89.4

IL 95.1 MO 87.0

OK 94.1

AR 91.9

MS

84.9

VT 85.6

NY

MI

80.1

81.4

PA

IN 87.0

OH 88.7

WV

89.8 VA

KY 91.9 85.4

83.6 TN 84.2

NC 89.7 SC

AL GA 79.0

76.4 81.7

ME 85.8

DC 67.1

MA 83.0 RI 78.0 CT 90.6 NJ 87.5 DE 86.8 MD 81.8

TX

LA

80.6

86.5

FL 84.7

Significantly higher than national average Not significantly different from national average Significantly lower than national average

SOURCE: CDC/NCHS, National Electronic Health Records Survey.

National average is 84.7%.

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NCHS Data Brief No. 195 March 2015

Did acceptance of new Medicare patients by office-based physicians differ by state?

In 2013, the percentage of physicians who accepted new Medicare patients ranged from 75.5% in Hawaii to 95.2% in North Dakota (Figure 4).

The percentage of physicians who accepted new Medicare patients was significantly higher than the national average (83.7%) in seven states (Minnesota, Nebraska, New Hampshire, North Dakota, Pennsylvania, South Dakota, and Wyoming).

Compared with the national average, no state had a significantly lower percentage of physicians accepting new Medicare patients.

Figure 4. Percentage of office-based physicians accepting new Medicare patients, by state: United States, 2013

WA 77.7

OR

76.3

ID

85.9

MT 87.9

WY 89.9

NV

80.8 UT

CA

87.5

77.2

CO 81.0

AZ 88.9

NM 86.9

AK

81.8

NH

94.5

ND 95.2 SD 92.2

MN 94.1 WI

89.1

NE 93.0

KS 84.7

IA 85.7

IL 88.7 MO 84.4

OK 86.0

AR 88.7

MS

84.1

VT 84.0

NY

MI

77.5

85.5

PA

IN 89.6

OH 87.7

WV

90.5 VA

KY 89.7 79.2

87.1 TN 84.3

NC 83.4 SC

AL GA 85.5

84.0 80.0

ME 84.9 MD 81.9

TX

LA

MA 79.4 RI 87.1 CT 86.1 NJ 82.6 DE 81.5 DC 76.1

HI

79.9

83.5

75.5

FL

88.4

Significantly higher than national average Not significantly different from national average

SOURCE: CDC/NCHS, National Electronic Health Records Survey.

National average is 83.7%.

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NCHS Data Brief No. 195 March 2015

Did acceptance of new Medicaid patients by office-based physicians differ by state?

In 2013, the percentage of physicians who accepted new Medicaid patients ranged from 38.7% in New Jersey to 96.5% in Nebraska (Figure 5).

The percentage of physicians who accepted new Medicaid patients was significantly lower than the national average of 68.9% in five states: California (54.2%), Florida (55.9%), Louisiana (56.8%), New Jersey (38.7%), and New York (57.1%).

The percentage of physicians accepting new Medicaid patients was significantly higher than the national average in 25 states.

Figure 5. Percentage of office-based physicians accepting new Medicaid patients, by state: United States, 2013

WA 71.3

OR

77.2

ID

86.8

MT 90.0

WY 93.9

NV

78.9 UT

CA

77.2

54.2

CO 70.4

AZ 70.1

NM 93.3

AK

89.9

NH

88.2

ND 96.2 SD 94.4

MN 94.1 WI

88.2

NE 96.5

KS 64.6

IA 89.6 IL

MO 73.2 70.2

OK 78.8

AR 89.8

MS

83.2

VT 83.2

NY

MI

57.1

69.6

PA

IN 85.8

OH 79.0

WV

81.0 VA

KY 82.5 70.0

83.0 TN 75.6

NC 80.1 SC

AL GA 72.3

67.5 71.9

ME 79.8 MD 65.7

TX

LA

MA 76.0 RI 71.0 CT 72.5 NJ 38.7 DE 80.0 DC 68.5

HI

57.6

56.8

68.3

FL

55.9

Significantly higher than national average Not significantly different from national average Significantly lower than national average

SOURCE: CDC/NCHS, National Electronic Health Records Survey.

National average is 68.9%.

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