Medicare and Medicaid Participation Rates for Doctors by State

October 20, 2016
Greg Kelly

Digging down a little deeper on the recently completed biennial survey of physicians by The Physicians Foundation, here are some details about how and where physicians do their jobs based on some important practice characteristics.

“The art of becoming wise is the art of knowing what to overlook.”

—William James

Some physicians are loyal to their states and wouldn’t leave regardless of what happened there. Other doctors tell me that they can’t stand things for one more day in their home state.

I frequently recall my physician-dad telling me that our home state of New Jersey was very bad for doctors. “Those bums in Trenton don’t give a damn about the medical profession,” he said. “And where would they be without us?”

Digging down a little deeper on the recently completed biennial survey of physicians by The Physicians Foundation, here are some details about how and where physicians do their jobs based on some important practice characteristics.

The lists below are the states with the five highest and lowest rates of physician participation in Medicare, Medicaid, and Accountable Care Organization (ACO) programs. Also find the states with the most and least amount of doctors who are still in private practice and those who are paid based on quality care metrics.

To find the state where doctors accept the lowest percentage of Medicare patients, head to Nevada. The doctors in South Dakota take sickly seniors the most. Doctors in Idaho are the most accepting of poor patients (those on Medicaid); New Jersey physicians are the least. As to Accountable Care Organization participation, Maine doctors lead the way and Alaska doctors are at the bottom.

Physicians in South Dakota are the highest percentage of private practitioners; Vermont the lowest. Doctors in Wisconsin are tops for being paid based on quality metrics; Alaska doctors are lowest.

The survey of more than 17,000 doctors was conducted by Merritt Hawkins, a leading physician search and consulting firm. Here’s what they found:

Percentage of physicians who say they currently do not see Medicare patients:

Top 5

Nevada 22.5%

Virginia 22.2%

New Jersey 18.9%

Arkansas 18.5%

Texas 18.4%

Bottom 5

South Dakota 2.9%

Maine 5.0%

North Dakota 5.6%

Montana 5.7%

Iowa 8.0%

Plus California (14.6%) and New York (15.2%)

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Percentage of physicians who say they currently do not see Medicaid patients:

Top 5

New Jersey 32.2%

Texas 29.9%

Florida 29.1%

Georgia 23.7%

California 22.1%

Bottom 5

Idaho 1.5%

Vermont 2.1%

South Dakota 2.9%

Montana 2.9%

Wyoming 3.2%

Plus New York (16.5%)

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Percentage of physicians who remain in independent private practice:

Top 5

South Dakota 45.9%

Texas 44.2%

New Jersey 44.1%

Georgia 41.9%

North Carolina 41.3%

Bottom 5

Vermont 7.8%

Wisconsin 12.8%

New Hampshire 17.2%

Massachusetts 17.7%

Indiana 19.9%

Plus California (34.7%) and New York (25.8%)

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Percentage of physicians who say they are in one or more ACOs:

Top 5

Maine 60.2%

Delaware 58.2%

Massachusetts 57.3%

Hawaii 55.1%

Iowa 54.7%

Bottom 5

Alaska 8.3%

Oklahoma 16.5%

Wyoming 17.2%

New Mexico 17.9%

West Virginia 22.1%

Plus California (31.1%) and New York (37.8%)

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Percentage of physicians who say their compensation is tied to quality metrics such as patient satisfaction, “citizenship,” and error rates:

Top 5

Wisconsin 64.1%

Hawaii 59.4%

Indiana 55.3%

Nebraska 51.9%

Delaware 51.6%

Bottom 5

Alaska 20.8%

Wyoming 27.3%

Mississippi 32.7%

New York 33.2%

Missouri 34.7%

Plus California (44.7%)


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