Doctors shy away from Medicaid, uninsured

The increasing financial squeeze on physicians is just beginning to be felt by the most susceptible patients.

By Joel B. Finkelstein, AMNews staff. Dec. 23/30, 2002.

Washington -- A falloff in the percentage of physicians serving Medicaid patients and the uninsured may reflect the growing strain on practice revenues, according to a new report.

Between 1997 and 2001, the proportion of physicians accepting Medicaid patients dropped from 87.1% to 85.4%.

During that same period, charity care among physicians decreased from 76.3% to 71.5%, according to the report published by the nonprofit Center for Studying Health System Change, based in Washington, D.C.

"Most physicians still provide charity care and treat Medicaid patients, but if physician costs continue to increase while payments decline, physicians will have no choice but to limit the amount of free and discounted care they provide in order to sustain their practices," said Yank Coble, MD, president of the American Medical Association.

The drop in physicians serving Medicaid and the uninsured is more likely to accelerate than reverse, said the report's author, Peter J. Cunningham, PhD.

Dr. Cunningham warned that the findings might be a harbinger of even more worrisome trends.

"Access to physicians is just one concern, [because] more general cost-containment measures being considered or implemented by states could also affect access to hospitals and prescription drugs among both Medicaid and uninsured patients," he wrote.

The report's findings suggest that there is a correlation between Medicaid payment rates and the proportion of practices closed to these patients. [...]