Can Medicaid beneficiaries access primary care providers?

In general the answer is yes, but often with some difficulty.  AJMC recaps the findings from a the CDC Morbidity and Mortality Weekly Report (MMWR) Quick Stats section from July 21, 2017.

88.9% of primary care physicians said they are accepting new patients, based on 2015 data from the National Electronic Health Records Survey. However, the survey found there are differences in acceptance rates based on the patient’s expected form of payment:

  • 94.2% of physicians accepted patients with private insurance
  • 77.4% of physicians accepted patients with Medicare
  • 71.6% of physicians accepted patients with Medicaid

Why is there such a big difference?  They key reason is physician reimbursement rates.

Daniel Polsky, PhD, MPP, an economist at the Wharton School at the University of Pennsylvania, ran an experiment in which field workers tried to get appointments, half posing as Medicaid recipients, and half posing as clients with private insurance. They did the experiment in 2012, before the ACA increased Medicaid payments and again in 2014, right after the pay boost took effect. The pay increase caused about an 8% increase in the number of people who could get appointments.

This is one clear example where having health insurance does not guarantee access to care.



  1. “This is one clear example where having health insurance does not guarantee access to care.” Maybe, but it also doesn’t say anything about the percentage of *uninsured* individuals who can/cannot get an appointment. Also, 94% is obviously higher than 72%, but is 72% low? Does this just mean that the Medicaid enrollee has to make 1 extra call? 2? 10? Or does the Medicaid enrollee know which doctors actually accept Medicaid enrollees (because of information on social networks) so that every time they make an appointment they are accepted? These data actually only cast a dim light on what there is to know about accessibility. More informative data would include information on the time elapsed from first contacting a doctor to actually seeing a doctor and the distance to travel for that appointment.

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