Fewer Physicians Seeing Medicaid and Charity Patients

December 9, 2002
The percentage of physicians providing charity care and treating Medicaid patients declined nearly five percent between 1997 and 2001, a study finds.

"The decline in physicians providing charity care and treating Medicaid patients is a sign of the financial pressures facing physicians," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded exclusively by The Robert Wood Johnson Foundation. "With substantial pressure on payment rates from private insurers, physicians may place a lower priority on treating the uninsured and Medicaid patients."

The proportion of physicians providing charity care declined nearly five percentage points -- from 76.3percent in 1997 to 71.5percent in 2001 while physicians treating Medicaid patients declined from 87.1percent to 85.4percent in that same time span, according to the study by the Centers for Studying Health System Change.

The study also found that the percentage of uninsured people who saw a physician in the year preceding the data collection dropped from 51.5 percent in 1997 to 46.6 percent. The number of Medicaid patients accessing care declined slightly, with 90.6 percent reporting a usual source of care in 2001 versus 92.9 percent in 1997.

The study's findings are detailed in an HSC Tracking Report—Mounting Pressures: Physicians Serving Medicaid Patients and the Uninsured, 1997-2001. The study is based on results from HSC's nationally representative Community Tracking Study Physician and Household Surveys, which involve about 12,000 physicians and 60,000 consumers, respectively.

Most physicians who treat charity care and Medicaid patients see relatively few of these patients. Among physicians providing any charity care in 2001, 70.2 percent spent less than 5 percent of their total practice time on charity care, while 29.8 percent spent 5 percent or more of their time on charity care.

Among physicians with any Medicaid revenue in 2001, more than half derived 10 percent or less of their total practice revenue from Medicaid, while about a quarter derived more than 20 percent of their revenue from Medicaid.

The report is available at http://www.hschange.org.