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Colorado Health Insurance Insider

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The Future Of PCP Availability For Medicare Beneficiaries

May 12, 2011 By Louise Norris

This week’s Health Wonk Review is up at InsureBlog – be sure to check it out.  I always appreciate facts and numbers in blog posts, and Jason Shafrin’s entry in the HWR includes lots of both.  He tackles the question of whether Medicare beneficiaries have to wait longer than privately insured patients for a routine appointment, and finds that they do not.  In fact, it appears that the opposite is true, with more privately insured patients reporting that they had to wait longer than they wanted to get an appointment (although most insureds, regardless of whether they had Medicare or private health insurance, were able to get appointments within the time frame they wanted).

Jason’s article noted that patients with Medicare had an easier time finding a PCP than privately insured patients.  This is particularly interesting given that another of the statistics he points out indicates that although most PCPs (83%) are still accepting new Medicare patients, this is a drop from the number who were accepting new Medicare patients in 2007 (88%).  The average reimbursement from Medicare was 80% of what a doctor could expect to get from a private health insurer, and we have to wonder whether the trend towards fewer PCPs accepting new Medicare patients will continue.  If it does, it’s likely that as time goes by, Medicare beneficiaries may have a harder time finding a PCP if they don’t already have one. Whether or not most PCPs continue to accept new Medicare patients likely depends quite a bit on what is done to fix the Medicare reimbursement formula – a problem that still doesn’t seem to have any great solutions.  The first wave of baby boomers turns 65 this year, so the ranks of Medicare beneficiaries will be growing at a rapid clip over the next couple decades.  Hopefully the trend of PCPs opting to not accept new Medicare patients will turn around – otherwise our seniors could find it quite a bit more difficult to find a doctor a decade from now.

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Filed Under: Health Care Goodies, Medicare

About Louise Norris

Louise Norris has been writing about health insurance and healthcare reform since 2006. In addition to the Colorado Health Insurance Insider, she also writes for healthinsurance.org, medicareresources.org, Verywell, Spark by ADP, and Boost by ADP, and Gusto. Follow on twitter and facebook.

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