Medicare, Medicaid Acceptance Rates

Laura Joszt

Given current numbers and health care industry forecasts, such as the implementation of the Affordable Care Act and possible Medicare spending cuts, the number of medical offices accepting Medicare and Medicaid may decline.

Given current numbers and health care industry forecasts, such as the implementation of the Affordable Care Act (ACA) and possible Medicare spending cuts, the number of medical offices accepting Medicare and Medicaid may decline, according to a new report.

The Physicians Office Acceptance of Government Insurance Programs report by SK&A revealed that 83.6% of physicians accept Medicare and 67% accept Medicaid. However, a 2011 survey showed that 31% of office-based physicians would not accept new Medicaid patients.

And yet, there will be even more Medicaid patients than ever. PricewaterhouseCoopers estimates that the ACA will mean 10 million more Americans will be on Medicaid.

"The findings of this survey are a valuable industry benchmark for the changes that we're seeing in healthcare per The Patient Protection & Affordable Care Act," said Dave Escalante, Senior Vice President of OneKey and Marketing at Cegedim Relationship Management, in a statement. "As the health care industry prepares to bring on more insured patients, doctors' acceptance of government insurance programs appears to be trending downward."

The physicians surveyed by SK&A revealed that the main influences when deciding to accept Medicare and Medicaid are the size and ownership of the practice. Larger, affiliated practices had a higher acceptance rate while smaller, non-affiliated practices have lower acceptance rates.

Of large practices with 26 or more physicians, 93.4% accepted Medicare patients and 91.3% accepted Medicaid.

Specialties also impacted acceptance, according to SK&A. Specialists were more likely to accept both programs than primary care physicians. Specialties with the highest Medicare acceptance rates were dialysis (98.1%), vascular and interventional radio (98%) and colon-rectal survey (97.7%). Dialysis also had the highest Medicaid acceptance rate at 97.5%.