Medicare and Medicaid Participation Rates for Doctors by State

OCTOBER 19, 2016
Greg Kelly
“The art of becoming wise is the art of knowing what to overlook.”
—William James

Some physicians are loyal to their states and wouldn’t leave regardless of what happened there. Other doctors tell me that they can’t stand things for one more day in their home state.

I frequently recall my physician-dad telling me that our home state of New Jersey was very bad for doctors. “Those bums in Trenton don’t give a damn about the medical profession,” he said. “And where would they be without us?”

Digging down a little deeper on the recently completed biennial survey of physicians by The Physicians Foundation, here are some details about how and where physicians do their jobs based on some important practice characteristics.

The lists below are the states with the five highest and lowest rates of physician participation in Medicare, Medicaid, and Accountable Care Organization (ACO) programs. Also find the states with the most and least amount of doctors who are still in private practice and those who are paid based on quality care metrics.

To find the state where doctors accept the lowest percentage of Medicare patients, head to Nevada. The doctors in South Dakota take sickly seniors the most. Doctors in Idaho are the most accepting of poor patients (those on Medicaid); New Jersey physicians are the least. As to Accountable Care Organization participation, Maine doctors lead the way and Alaska doctors are at the bottom.

Physicians in South Dakota are the highest percentage of private practitioners; Vermont the lowest. Doctors in Wisconsin are tops for being paid based on quality metrics; Alaska doctors are lowest.

The survey of more than 17,000 doctors was conducted by Merritt Hawkins, a leading physician search and consulting firm. Here’s what they found:
Percentage of physicians who say they currently do not see Medicare patients:
Top 5
Nevada                            22.5%
Virginia                             22.2%
New Jersey                      18.9%
Arkansas                          18.5%
Texas                                18.4%
Bottom 5
South Dakota                    2.9%
Maine                                5.0%
North Dakota                     5.6%
Montana                            5.7%
Iowa                                   8.0%
Plus California (14.6%) and New York (15.2%)
Percentage of physicians who say they currently do not see Medicaid patients:
Top 5
New Jersey                        32.2%
Texas                                  29.9%
Florida                                29.1%
Georgia                               23.7%
California                             22.1%
Bottom 5
Idaho                                   1.5%
Vermont                               2.1%
South Dakota                       2.9%
Montana                               2.9%
Wyoming                              3.2%
Plus New York (16.5%)
Percentage of physicians who remain in independent private practice:
Top 5
South Dakota                       45.9%
Texas                                   44.2%
New Jersey                          44.1%
Georgia                                41.9%
North Carolina                      41.3%
Bottom 5
Vermont                                7.8%
Wisconsin                             12.8%
New Hampshire                    17.2%
Massachusetts                      17.7%
Indiana                                  19.9%
Plus California (34.7%) and New York (25.8%)
Percentage of physicians who say they are in one or more ACOs:
Top 5
Maine                                     60.2%
Delaware                                58.2%
Massachusetts                       57.3%
Hawaii                                    55.1%
Iowa                                       54.7%
Bottom 5
Alaska                                    8.3%
Oklahoma                              16.5%
Wyoming                                17.2%
New Mexico                            17.9%
West Virginia                           22.1%
Plus California (31.1%) and New York (37.8%)
Percentage of physicians who say their compensation is tied to quality metrics such as patient satisfaction, “citizenship,” and error rates:
Top 5
Wisconsin                                64.1%
Hawaii                                     59.4%
Indiana                                    55.3%
Nebraska                                 51.9%
Delaware                                 51.6%
Bottom 5
Alaska                                      20.8%
Wyoming                                  27.3%
Mississippi                               32.7%
New York                                 33.2%
Missouri                                   34.7%
Plus California (44.7%)

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