State Variation in Primary Care Physician Supply

Implications for Health Reform Medicaid Expansions

This study finds that in much of the country, Medicaid enrollment expansion under health reform is likely to greatly outpace growth in the number of primary care physicians (PCPs) willing to treat these new patients. Funded by the Robert Wood Johnson Foundation and authored by Peter J. Cunningham, Ph.D., senior fellow, Center for Studying Health System Change (HSC), the study finds that under federal health reform, Medicaid eligibility will expand to cover as many as 16 million more poor and low-income adults by 2019—an increase of more than 25 percent. Nationally, 42 percent of PCPs in 2008 were accepting all or most new Medicaid patients, compared with 61 percent accepting all or most new Medicare patients, and 84 percent accepting all or most privately insured patients.

Nationwide, PCP supply varies considerably by region. States with the largest number of PCPs per capita are concentrated almost entirely in the Mid-Atlantic and Northeast. Conversely, states with the smallest number of PCPs per capita are concentrated largely in the South and Mountain West—those regions that will potentially see the largest percentage increases in Medicaid enrollment in the years ahead. Cunningham also notes that the temporary increases in reimbursement meant to entice more PCPS to accept new Medicaid patients are unlikely to make a significant difference in states facing the biggest enrollment jumps. The study was based on HSC’s nationally representative 2008 Health Tracking Physician Survey, which includes responses from more than 4,700 physicians.

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