In 2011 Nearly One-Third Of Physicians Said They Would Not Accept New Medicaid Patients, But Rising Fees May Help
In 2011 Nearly One-Third Of Physicians Said They Would Not Accept New Medicaid Patients, But Rising Fees May Help
复制标题
DOI：
10.1377/hlthaff.2012.0294
复制
发表时间：
2012-08-01
期刊：
影响因子：
9.7
通讯作者：
Decker, Sandra L.
中科院分区：
文献类型：
--
作者：
Decker, Sandra L.
全面实施后，《平价医疗法案》将扩大拥有医疗保险的人数。这引发了人们对卫生保健工作人员满足日益增长的需求的能力的质疑。我使用了2011年全国门诊医疗保健调查电子病历补充资料中有关办公室医生的数据，以总结目前接受任何新患者的医生的百分比。尽管96%的医生在2011年接受了新患者，但费率因支付来源而异：31%的医生不愿接受任何新的联邦医疗补助患者；17%的医生不会接受新的联邦医疗保险患者；18%的医生不会接受新的私人保险患者。与其他医生相比，较小诊所和大都市地区的医生接受新的医疗补助患者的可能性较小。较高的州医疗补助与医疗保险费用比率与更好地接受新的医疗补助患者相关。这些发现是一个有用的基线，可以用来衡量《平价医疗法案》条款的预期影响，这些条款可能会提高一些州初级保健医生的医疗补助支付率，同时增加医疗保险覆盖的人数。
When fully implemented, the Affordable Care Act will expand the number of people with health insurance. This raises questions about the capacity of the health care workforce to meet increased demand. I used data on office-based physicians from the 2011 National Ambulatory Medical Care Survey Electronic Medical Records Supplement to summarize the percentage of physicians currently accepting any new patients. Although 96 percent of physicians accepted new patients in 2011, rates varied by payment source: 31 percent of physicians were unwilling to accept any new Medicaid patients; 17 percent would not accept new Medicare patients; and 18 percent of physicians would not accept new privately insured patients. Physicians in smaller practices and those in metropolitan areas were less likely than others to accept new Medicaid patients. Higher state Medicaid-to-Medicare fee ratios were correlated with greater acceptance of new Medicaid patients. The findings serve as a useful baseline from which to measure the anticipated impact of Affordable Care Act provisions that could boost Medicaid payment rates to primary care physicians in some states while increasing the number of people with health care coverage.