Accepting new patients based on payment source
CDC
MMWR
March 16, 2007
QuickStats: Percentage of Office-Based Primary-Care Physicians Who Did Not Accept New Patients, by Expected Payment Source — National Ambulatory Medical Care Survey, United States, 2003—2004
Although 94.2% of primary-care physicians reported in 2003—2004 that they were accepting new patients, acceptance varied by the patient’s expected payment source.
Percent who did not accept new patients, by expected payment source:
43.0% - Charity or no charge
42.3% - Workers’ compensation
31.6% - Capitated private insurance
29.3% - Medicaid
20.3% - Medicare
11.4% - Noncapitated private insurance
7.0% - Self-pay
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5610a8.htm?s_cid=mm5610a8_e
Full CDC report, “Characteristics of Office-Based Physicians and Their Practices: United States, 2003-04:”
http://www.cdc.gov/nchs/data/series/sr_13/sr13_164.pdf
Comment:
By Don McCanne, MD
Most office-based primary-care physicians are accepting new patients, but they understandably are concerned about the prospect of receiving adequate payment for their services.
How many of these physicians do you believe enjoy making practice policy decisions based on various potential payment sources? Doesn’t it seem logical that physicians would prefer to make decisions based strictly on the patients’ health care needs, without having to consider how the care is to be funded?
Under a single-payer national health insurance program, a question about accepting new patients based on expected payment source would never have to be asked.
More importantly, how often have you seen surveys in which patients report that they are unable to find a physician who is taking new patients? Well, most of them are, but often only after the patients pass the screening questions for health care payment. At a time when access to primary care has become a major problem, shouldn’t we take the first step of removing this major barrier to care?
We also need to improve incentives for students to select careers in primary care. It would be far simpler to realign incentives through the supply side mechanisms of the single payer model. In fact, demand side approaches impair access by inserting financial barriers to care when our goal should be to improve access. Single payer would remove those barriers.