Are Physicians Closing Their Doors to Medicare? Trends and Patterns in the Provision of Physician Services to Medicare Patients

Martey S. Dodoo, AAFP Center for Policy Studies

Our objective was to obtain credible evidence on whether physicians are closing their doors to Medicare beneficiaries. We analyzed full year Medicare outpatient claims data from four State-wide representative cross-sectional and four longitudinal physician samples (1996, 2000, 2003, and 2006). Measured access as percentage of physicians providing services to at least one “new” beneficiary and average number of “new” patient visits per 1,000 beneficiaries per year. Used SAS-callable SUDAAN (v10) and MPlus for analyses. Regardless of specialty, age-group or sample, each year, physicians cut their “new” beneficiary visits. In 1996-2000 by 4.2%, 7.7% (2000-2003), and 2.2% (2003-2006). Average annual number of new visits per 1000 beneficiaries dropped to below 50 for physicians of all ages. Physicians in rural areas were more likely to limit new patient visits compared to urban physicians. In all cases there was a decrease in access to physicians from 1996 to 2006.