Hest, Robert
Senior Research Fellow

p 612-624-5507
e hestx005@umn.edu

Assessing Physician Acceptance of Medicaid Patients Using State Health Compare

In order for the more than 80 million Medicaid beneficiaries to access needed care in a timely manner, there must be a sufficient number of health care providers to serve these patients. There has long been concern that providers are less likely to accept Medicaid patients than patients with other types of health insurance coverage, making it difficult for individuals with Medicaid coverage to get health care when they need it. In the U.S., nearly all physicians accept new patients with private insurance, but only about three quarters accept new patients with Medicaid coverage. Though this trend is clear nationally, there is a large degree of variation across the states in how likely physicians are to accept new patients with Medicaid coverage compared to other forms of insurance.

SHADAC’s State Health Compare has two state-level measures related to physician acceptance of new Medicaid patients, allowing users to compare rates of physician acceptance of new patients by coverage type (Medicaid, Private, and Medicare) and to compare rates of physician acceptance of new Medicaid patients by characteristics of the physician’s practice, along with more than 40 other state-level measures of health insurance coverage; health behaviors; access, affordability, and use of care; public health; and related social and economic factors.

Nationally, in 2014–2017, while more than 95 percent of physicians said they accepted new patients with private insurance, only 74 percent accepted new patients with Medicaid coverage (among physicians accepting new patients), a greater than 20 percentage-point gap.

This gap was much larger in some states than others. For example, in New Jersey, Florida, Louisiana, and California, physicians were more than 30 percentage-points less likely to accept new patients with Medicaid coverage than those with private insurance. And in New Jersey, less than half of physicians said they accepted new patients with Medicaid (42.2%). However, in twelve states, physicians were no more than five percentage points less likely to accept Medicaid patients than private patients, and in Wisconsin, Minnesota, and North Dakota, there was essentially no difference between physicians’ acceptance of Medicaid versus private insurance.

Though the Affordable Care Act (ACA) led to important policy changes that could have prompted shifts in the share of physicians who accept Medicaid patients, rates of acceptance of Medicaid patients have been stable over time nationally and in most states, both before most ACA coverage policies were implemented (2011–2013) and after these policies were in force (2014–2017).

Nationally, the percentage of physicians accepting new Medicaid patients was statistically unchanged between 2011–2013 and 2014–2017, remaining between 73 and 74 percent. Six states—Idaho, Massachusetts, Missouri, Ohio, Vermont, and West Virginia—saw significant increases in the percent of physicians accepting Medicaid patients. Of these states, Missouri saw the largest increase, with 78 percent of physicians accepting Medicaid-covered patients in 2014–2017 compared to less than 69 percent in 2011–2013, a greater than nine percentage-point increase.

Six states saw increases in the share of physicians accepting new Medicaid patients
 

Visit SHADAC’s State Health Compare to dive deeper into state-level trends for these two measures: 

• Physician acceptance of new patients by coverage type
• Factors associated with physician acceptance of Medicaid patients 

Related Resource
SHADAC brief summarizing Dr. Hannah Neprash’s study examining the effects of Medicaid expansion on physician participation

Notes
Estimates in this post are representative of non-federally employed office-based physicians who are primarily engaged in direct patient care and reported accepting new patients. Data years 2011–2013 and 2014–2017 were merged to improve sample sizes and facilitate the production of state-level estimates. Estimates represent a weighted average of the years in these periods.

Differences between physician acceptance of Medicaid versus private insurance were not evaluated for statistical significance. All described differences in physician acceptance of Medicaid coverage over time were statistically significant at the 95% confidence level.

All data in this post come from SHADAC analysis of the 2011–2017 National Electronic Health Records Survey (NEHRS) data, produced by the National Center for Health Statistics (NCHS). The analysis was performed by SHADAC under contract with the Medicaid and CHIP Payment and Access Commission (MACPAC). The findings, statements, and views expressed here are those of SHADAC and do not necessarily reflect those of MACPAC. Data were analyzed at the University of Minnesota's Census Research Data Center. Data for 2016 are not available.