Medicare Seniors’ Access to Physician Care Stabilized between 2001 and 2003

After a significant decline in 2001, Medicare seniors' access to physician services stabilized in 2003, according to a national study released today by the Center for Studying Health System Change (HSC).

Similar to Medicare seniors, privately insured near-elderly people between the ages of 55 and 64 experienced a spike in access problems in 2001, indicating system-wide capacity constraints were curtailing access to physician services for both groups of patients. Nonetheless, policy makers worried that a 5.4 percent Medicare physician payment cut in 2002 might limit seniors' access to physician care.

However, 9.9 percent of Medicare seniors reported delaying or not getting needed medical care in 2003 compared with 11 percent in 2001 and 9.1 percent in 1997, according to HSC's Community Tracking Study 2003 Household Survey, a nationally representative survey involving information on 46,600 people, including 6,900 Medicare beneficiaries 65 and older.

Mirroring the trend for Medicare seniors, the proportion of privately insured near-elderly people reporting access problems in 2003 was 17.4 percent compared with 18.4 percent in 2001 and 15.2 percent in 1997. 

The HSC study complements a recent Government Accountability Office (GAO) report that found the proportion of Medicare beneficiaries receiving physician services and the number of services provided to beneficiaries both increased between April 2000 and April 2002.

The HSC study's findings are detailed in a new Issue Brief—An Update on Medicare Beneficiary Access to Physician Services. Other key findings include:

• The proportion of Medicare seniors seeing a doctor at least once in the previous year increased to 92 percent in 2003, up from 87 percent in 1997. Likewise, Medicare seniors reported having 5.5 physician visits a year in 2003 on average, up from 5.2 visits in 1997.
•  Medicare seniors and privately insured near-elderly people both waited longer for appointments to primary care providers and specialists. For example, Medicare seniors waited on average about 12 days in 2003 to see their primary care provider for a checkup compared with 10 days in 1997. For privately insured near-elderly people, the average waiting time for a checkup appointment with their primary care provider rose from 11 days to almost 14 days.