Medicare Beneficiaries' Access to Physicians

Access is an important component of the Triple Aim (cost, quality, access), and it has also been stressed as a significant factor in health reform initiatives. As the influx of uninsured increasingly seeks care, and if the number of providers available to provide primary care decreases as projected, achieving access to quality and cost-effective care may become more problematic.

However, according to the Kaiser Family Foundation, survey findings showed that 96% of Medicare beneficiaries had little trouble in accessing a doctor’s office or clinic. And 90% reported no issues with scheduling appointments for care, routine or otherwise.

“Multiple national surveys find that the vast majority of people with Medicare have a usual source of care for when they are sick or seeking medical advice,” stated the report. “This key indicator of access to care is particularly important for Medicare beneficiaries because they tend to have more chronic conditions and medical needs than others.”

Only about 2% of Medicare beneficiaries voiced concern about finding a new physician, which is comparable to the percentage of those with private insurance to have that concern. However, some subgroups of beneficiaries did experience barriers to access, including those without supplemental insurance or Medicaid.

“While the majority of Medicare beneficiaries report having a usual source of care and do not forgo needed physician visits, certain subgroups of Medicare beneficiaries have higher rates of access problems that warrant close attention,” details the report. “These include beneficiaries with no supplemental insurance or Medicaid, beneficiaries under age 65 living with a permanent disability, beneficiaries in fair and poor health, beneficiaries with four or more chronic conditions, and beneficiaries with lower incomes. For the most part, however, even among these subgroups, most do not report significant problems securing access to medical care when needed.”

As baby boomers continue to increase the Medicare population, continued efforts will be needed to ensure that beneficiaries have sufficient access to quality and affordable care.

Around the Web

Medicare Beneficiaries Have Good Access To Doctors, Study Finds

[Washington Post]

Medicare Patients’ Access to Physicians: A Synthesis of the Evidence [Kaiser Family Foundation]