Cardiology near top for accepting Medicare

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 - Interoperabilty

A recent survey of physician offices in the U.S. found that 83.6 percent accept Medicare and 67 percent accept Medicaid, with cardiologists having one of the highest rates among specialists.

SK&A surveyed 271,451 U.S. office-based physician medical offices about their acceptance of the government-funded programs Medicare and Medicaid. The results showed acceptance to be largely influenced by variables such as the size and ownership of the physician practices, with larger, affiliated practices correlating with higher acceptance rates. Conversely, smaller, non-affiliated practices have lower acceptance rates.

Large practices with 26 or more physicians were more likely to accept Medicare (93.4 percent) and Medicaid (91.3 percent) than smaller practices with between one and 10 physicians, according to survey results. Practices with higher patient volumes also were more likely to accept these programs. Offices with daily patient volumes greater than 31 had an acceptance rate of 85.5 percent for Medicare and 69.6 percent for Medicaid. 

The ownership of practices also influenced Medicare and Medicaid acceptance policies. Acceptance of Medicare was higher with healthcare-system-owned (89.4 percent) and hospital-owned practices (89.1 percent) compared with non-healthcare-system-owned practices (82.7 percent) and non-hospital-owned practices (82.7 percent). Medicaid acceptance rates were also much higher in healthcare-system-owned (82.5 percent) and hospital-owned (84.4 percent) practices. Medicaid acceptance was significantly lower in non-healthcare-system-owned practices (64.7 percent) and non-hospital-owned practices (64.2 percent).

SK&A also found that acceptance rates varied by physician specialty. Overall, for Medicare and Medicaid, specialists were more likely to accept both than primary care physicians (family practice, general practice, internal medicine and pediatrics). Specialties with the highest Medicare acceptance rates were dialysis (98.1 percent), vascular and interventional radio (98 percent), colon-rectal surgery (97.7 percent) and cardiology (95.22 percent). Dialysis is covered through Medicare, regardless of the age of the patient.

Specialties with the lowest Medicare acceptance rates were pediatrics (28.8 percent), occupational medicine (27 percent) and holistic medicine (21.4 percent).

For Medicaid, the top three physician specialties that accept the program were dialysis (97.5 percent), critical care medicine (95 percent) and nephrology (93 percent). The rate for cardiology was 83.48 percent. The lowest acceptance rates for Medicaid come from bariatrics (24.5 percent), occupational medicine (14.7 percent) and holistic medicine (9.2 percent).

Dave Escalante, senior vice president of OneKey and Marketing at Cegedim Relationship Management, said that the results will serve as a benchmark going into the transition in healthcare with the Patient Protection and Affordable Care Act. “As the healthcare industry prepares to bring on more insured patients, doctors’ acceptance of government insurance programs appears to be trending downward,” he said in a release.

The “Physician Office Acceptance of Government Insurance Programs” report was based on telephone interviews and was completed by SK&A , a Cegedim company based in Irvine, Calif.