Doctors Accept Fewer Patients with Private Insurance

Doctors are accepting fewer and fewer patients with private health insurance, narrowing access to the nation’s health care system, said Dr. Tara Bishop, assistant professor of public health at Weill Cornell Medical College.

Physicians’ acceptance of patients with traditional fee-for-service private insurance fell from 93.3 percent in 2005 to 87.8 percent in 2008, said Bishop, the lead author of a study that appeared in the June 27^th issue of the Archives of Internal Medicine.

The change could stem from inadequate reimbursement from insurance companies failing to keep pace with current costs, said Bishop. Doctors may also be reluctant to work within the restrictions and rules imposed by insurance companies.

The study has serious implications for health care under the Patient Protection and Affordable Care Act of 2010. The legislation will add millions of Americans to the ranks of the insured, but their access to health care could be hampered by doctor’s growing reluctance to work within insurance parameters.

“At a moment when the country is poised to achieve near-universal coverage, patients’ access to care could be a casualty of the collision between the medical profession and the insurance industry,” said Bishop in a press released issued by New York-Presbyterian Hospital where she is a practicing physician.

Bishop analyzed data from the CDC’s Center for Health Statistics and found an overall decline in physician acceptance of several forms of insurance coverage. Not surprisingly, acceptance of Medicare and Medicaid patients also declined.

Bishop’s study adds to the growing body of research quantifying the growing gap between insurance benefits and the costs of medical care. The rising number of underinsured Americans worry they may not be able to afford health care, a fear that’s fueling the supplemental health insurance industry.

A 2009 Commonwealth Fund report put the number of underinsured Americans at 25 million. An underinsured worker is one whose medical expenses exceed 10 percent of their annual income, or their health-care deductibles equal or exceed 5 percent of their annual income.

The prospect of a family health catastrophe worries even the wealthiest investors. Our research shows that more than half of investors with $1 million to $5 million are concerned about the financial impact of a family health catastrophe, as do 60 percent of investors with $100,000 to $1 million.