SK&A Releases Study On Acceptance Of Medicare And Medicaid Programs By U.S. Medical Offices

Main Category: Medicare / Medicaid / SCHIP
Article Date: 28 Oct 2009 - 2:00 PDT

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With last month's U.S. Census Bureau report showing that the number of Americans supported by government-sponsored health insurance plans rose to 87.4 million in 2008 -- 29% of the U.S. population -- SK&A, a leading provider of healthcare information and research, today released its Physician Office Acceptance of Government Insurance Programs Report, which reveals that 83% of U.S. medical offices accept Medicare and 65% accept Medicaid.

SK&A surveyed 178,000 U.S. office-based physician medical offices about their acceptance of the government-funded programs Medicare and Medicaid. The survey found Medicare and Medicaid acceptance to be largely influenced by variables such as the size, ownership, location and specialty of the physician practices.

For example, large practices with 26 or more physicians are more likely to accept Medicare (87.1%) and Medicaid (83.6%) than smaller practices with between one and 10 physicians. The higher the patient volume, the more likely it is the practices accept these programs. Offices with daily patient volumes greater than 31 have acceptance rates of 84% for Medicare and 68.4% for Medicaid.

The ownership of the practice is influential in Medicaid acceptance policies. Acceptance of Medicaid is higher with hospital-owned practices (82.1%) compared with non-hospital-owned practices (62.9%). For Medicare, acceptance patterns did not vary significantly by ownership.

SK&A also found that acceptance rates vary by physician specialty. Specialties with the highest Medicare acceptance rates are podiatry (97.6%), thoracic surgery (97.5%) and colon-rectal surgery (97%). Specialties with the lowest Medicare acceptance rates are occupational medicine (16%), holistic medicine (23.2%) and bariatrics (27.7%).

For Medicaid, the top three physician specialties that accept the program are dialysis (95.8%), nephrology (91.8%) and thoracic surgery (91.5%). The lowest acceptance rates for Medicaid come from, like in Medicare, occupational medicine (10%), holistic medicine (10.7%) and bariatrics (13.1%).

The Physician Office Acceptance of Government Insurance Programs Report (Insurance Report) was completed in the SK&A Research Center in Irvine, Calif., where a team of 75 Research Associates telephone-verifies the company's multidimensional databases of two million healthcare contacts and provides custom research for clients to achieve specific outcomes.

The best uses for SK&A's recent Insurance Report include:

-- Providing support for healthcare insurance billing and coding accuracy
-- Updating healthcare insurance network directories for members
-- Supporting online physician lookup directories for consumers and patients
-- Identifying the general and specific market size of public insurance programs

Source
SK&A Information Services, Inc.