NCHS Data Brief ■ No. 138 ■ December 2013

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Rates of private insurance and public coverage have been increasing (1,2). 

As coverage and utilization increase, a growing concern is the availability 

of health care providers to meet patient needs (3). Almost 90% of general 

physicians accept new patients with private insurance, but less than 75% 

accept new patients with public coverage (e.g., Medicare, Medicaid), and the 

proportion of specialists accepting new patients with Medicare or Medicaid is 

declining (4). While most studies approach access from a provider perspective, 

this report examines the percentage of people who had each of three adverse 

experiences with physician availability in the past 12 months. Estimates were 

produced by age group and health insurance status using data from the 2012 

National Health Interview Survey (NHIS). 

Keywords: health care access • National Health Interview Survey

In the 12 months prior to interview, adults aged 18–64 were 

more likely than other age groups to have had selected 

adverse experiences with physician availability. 

Key findings

Data from the National 

Health Interview Survey, 

2012

• In the 12 months prior to 

interview, 2.4% of people 

in the U.S. had problems 

finding a general doctor, 2.1% 

had been told that a doctor 

would not accept them as new 

patients, and 2.9% had been 

told that a doctor did not accept 

their health care coverage. 

• People under age 65 who 

had public coverage only 

were more likely than those 

with private insurance to have 

these three types of adverse 

experiences with physician 

availability. 

• Adults aged 18–64 who 

were uninsured were more 

likely than privately insured 

adults to have trouble finding a 

general doctor or be told that a 

doctor would not accept them 

as new patients. 

• Adults aged 65 and over 

with Medicare only were 

as likely as those with both 

Medicare and private insurance 

to have these experiences with 

physician availability. 

Health Insurance Coverage and Adverse Experiences With 

Physician Availability: United States, 2012

Renee M. Gindi, Ph.D.; Whitney K. Kirzinger, M.P.H.; and Robin A. Cohen, Ph.D.

All ages 0–17 years 18–64 years 65 years and over

0

2

4

6

8

10

Doctor did not accept their

health care coverage

Doctor would not accept

them as new patient

Trouble finding

general doctor

Figure 1. Percentage of people who had selected experiences with physician availability in the 

past 12 months, by age group: United States, 2012

1

Significantly different from adults aged 18–64.

2

Significantly different from adults aged 65 and over.

NOTE: Data are based on household interviews of a sample of the civilian noninstitutionalized population. 

SOURCE: CDC/NCHS, National Health Interview Survey, 2012. Percent

2.4 2.1

2.9

1

1.5 1

1.5

1

2.4

2

3.0 2

2.5

2

3.3

1.4 1.4

2.1
NCHS Data Brief ■ No. 138 ■ December 2013

■  2  ■

Three types of experiences with physician availability were analyzed. Among people of all ages 

in the United States, in the 12 months prior to interview, 2.4% had problems finding a general 

doctor, 2.1% had been told that a doctor’s office or clinic would not accept them as new patients, 

and 2.9% had been told that a doctor’s office or clinic did not accept their health care coverage 

(Figure 1). Rates for each of these problems varied by age group. Adults aged 18–64 were more 

likely than children aged 0–17 years and adults aged 65 and over (older adults) to have had each 

of these experiences with physician availability. The proportions of children and older adults 

having each of these experiences with physician availability were similar.

Among people under age 65, those who had public coverage only or were 

uninsured had more trouble finding a general doctor in the past year than 

those with private insurance.

In 2012, in the 12 months prior to interview, 5.1% of adults aged 18–64 with public coverage 

only had trouble finding a general doctor (Figure 2). This was similar to the percentage of 

uninsured adults aged 18–64 who had trouble finding a general doctor. A similar pattern was seen 

among children aged 0–17 years; those who had public coverage only were just as likely to have 

trouble finding a general doctor in the past year (2.3%) as those who were uninsured (2.9%). In 

both of these age groups, those with private insurance were the least likely to have trouble finding 

a general doctor. Among adults aged 65 and over with Medicare, similar percentages of those 

with and without private insurance had trouble finding a general doctor in the past year. 

Figure 2. Percentage of people who had trouble finding a general doctor in the past 12 months, by age group and health

insurance status: United States, 2012

* Estimates for uninsured adults aged 65 and over are not shown because they do not meet standards of reliability.

1

Significantly different from private (p < 0.05).

NOTE: Data are based on household interviews of a sample of the civilian noninstitutionalized population. 

SOURCE: CDC/NCHS, National Health Interview Survey, 2012. Percent

0

2

4

6

8

10 Uninsured Public only Private Medicare without

private insurance

Medicare with

private insurance

0–17 18–64 65 and over*

Age group in years

1

2.9 1

2.3

0.8

1

5.8

1

5.1

1.7 1.5 1.3
NCHS Data Brief ■ No. 138 ■ December 2013

■  3  ■

Among people under age 65, those who had public coverage only were 

more likely to have been told that a doctor’s office or clinic would not 

accept them as new patients in the past year than those with private 

insurance.

In the 12 months prior to interview, adults aged 18–64 with public coverage only were almost 

four times as likely as those with private insurance and about twice as likely as those who were 

uninsured to encounter a doctor’s office or clinic that would not accept them as new patients 

(Figure 3). These differences were less pronounced among children: Children with public 

coverage only (2.3%) and uninsured children (1.7%) had similar percentages of being told that 

a doctor’s office or clinic would not accept them as new patients. However, children with public 

coverage only were still more than twice as likely as children with private insurance to have 

had this experience with physician availability. Among adults aged 65 and over with Medicare, 

similar percentages of those with and without private insurance were told that a doctor’s office or 

clinic would not accept them as new patients in the past year. 

Figure 3. Percentage of people who were told in the past 12 months that a doctor’s office or clinic would not accept

them as new patients, by age group and health insurance status: United States, 2012

* Estimates for uninsured adults aged 65 and over are not shown because they do not meet standards of reliability.

1

Significantly different from private (p < 0.05). 2

Significantly different from public (p < 0.05).

NOTE: Data are based on household interviews of a sample of the civilian noninstitutionalized population. 

SOURCE: CDC/NCHS, National Health Interview Survey, 2012. Percent

0

2

4

6

8

10 Uninsured Public only Private Medicare without

private insurance

Medicare with

private insurance

0–17 18–64 65 and over*

Age group in years

1.7

1

2.3

0.8

1,2

3.1

1

5.9

1.6 1.4 1.4
NCHS Data Brief ■ No. 138 ■ December 2013

■  4  ■

Among insured people under age 65, those who had public coverage only 

were more likely than those with private insurance to have been told in the 

past year that a doctor’s office or clinic did not accept their health care 

coverage.

In 2012, 8.3% of adults aged 18–64 with public coverage only were told that a doctor’s office or 

clinic did not accept their health care coverage in the past year. This was more than three times 

higher than the percentage for adults with private insurance in that age group (Figure 4). A similar 

relationship was observed among children: 3.8% of children with public coverage only were told 

that a doctor’s office or clinic did not accept their health care coverage, a percentage almost three 

times higher than for children with private insurance. Among older adults with Medicare, similar 

percentages of those with and without private insurance were told in the past year that a doctor’s 

office or clinic did not accept their health care coverage.

Figure 4. Percentage of people with health insurance who were told in the past 12 months that a doctor’s office or clinic

did not accept their health care coverage, by age group and coverage type: United States, 2012

1

Significantly different from private (p < 0.05). 

NOTE: Data are based on household interviews of a sample of the civilian noninstitutionalized population. 

SOURCE: CDC/NCHS, National Health Interview Survey, 2012. Percent

0

2

4

6

8

10 Public only Private Medicare without

private insurance

Medicare with

private insurance

0–17 18–64 65 and over

Age group in years

1

3.8

1.3

2.6

1

8.3

2.4

1.9
NCHS Data Brief ■ No. 138 ■ December 2013

■  5  ■

Summary

In 2012, in the 12 months prior to interview, 2.4% of people in the United States had problems 

finding a general doctor, 2.1% had been told that a doctor’s office or clinic would not accept them 

as new patients, and 2.9% had been told that a doctor’s office or clinic did not accept their health 

care coverage. Each of these problems was experienced most often by adults aged 18–64, and 

rates varied by health insurance coverage. Uninsured adults aged 18–64 were as likely as adults 

with public coverage only to have problems finding a general doctor, but were less likely to be 

told that a doctor would not accept them as new patients. This is consistent with recent surveys, 

which indicate that while 89% of general doctors accept new self-pay patients, fewer accept 

new Medicare or Medicaid patients (4). While people under age 65 who had public coverage 

only were more likely to have these types of experiences than those with private insurance, 

this difference between insurance coverage types was not observed among adults aged 65 and 

over with Medicare: Rates were similarly low for those older Medicare-insured adults with and 

without additional private insurance. 

Concerns about physician shortages have previously been based on provider surveys, models 

based on physician productivity, and ratios of the number of physicians to the size of the 

population (3–5). The present findings are based on a survey of the civilian noninstitutionalized 

population and suggest that the experiences with physician availability analyzed here are not 

common in all age and insurance coverage groups. However, the 2012 NHIS does not ask 

whether a person has tried to find a physician in the past year; those who have not tried to find a 

physician in the past year likely did not report having trouble finding a physician. 

The three types of experiences with physician availability are neither mutually exclusive nor 

exhaustive; individuals may report more than one experience, and the percentages should not be 

added to summarize experiences with physician availability. In addition, this report represents 

only some aspects of experiences with physician availability. For example, people who use 

targeted strategies for finding a physician (e.g., lists of in-network providers, recommendations) 

would be less likely to report encountering doctors who would not accept their insurance or 

accept them as new patients. The Centers for Disease Control and Prevention’s (CDC) National 

Center for Health Statistics (NCHS) will continue to monitor patient experiences with physician 

availability as insurance coverage and health care utilization rates change.
NCHS Data Brief ■ No. 138 ■ December 2013

■  6  ■

Definitions

Trouble finding a general doctor in the past 12 months: Defined by an affirmative answer to 

the question, “During the past 12 months, did you have any trouble finding a general doctor or 

provider who would see you/[child’s name]?” This was asked of all sample adults and children, 

regardless of whether they had tried to find a doctor in the past 12 months.

Doctor’s office or clinic would not accept new patients in the past 12 months: Defined by an 

affirmative answer to the question, “During the past 12 months, were you told by a doctor’s office 

or clinic that they would not accept you/[child’s name] as a new patient?” This was asked of all 

sample adults and children, regardless of whether they had tried to find a doctor in the past 12 

months.

Doctor’s office or clinic did not accept health care coverage in the past 12 months: Defined by an 

affirmative answer to the question, “During the past 12 months, were you/[child’s name] told by 

a doctor’s office or clinic that they did not accept your health care coverage?” This was asked of 

all sample adults and children, regardless of whether they had tried to find a doctor in the past 12 

months. In Figure 1, estimates were calculated for all respondents. In Figure 4, estimates were 

calculated only for respondents with either public coverage or private insurance at the time of the 

interview. 

Health insurance or health care coverage: NHIS respondents were asked about their health care 

coverage at the time of interview. Respondents reported whether they were covered by private 

health insurance (obtained through the employer or workplace, purchased directly, or purchased 

through a local or community program), Medicare, Medigap (supplemental Medicare coverage), 

Medicaid, Children’s Health Insurance Program, Indian Health Service (IHS), military coverage 

(including VA, TRICARE, or CHAMP–VA), a state-sponsored health plan, another government 

program, or any single-service plan. For children aged 0–17 years and adults aged 18–64, this 

information was used to form three mutually exclusive categories: people with private health 

insurance (private), which may include people who also have public sources like Medicare; 

public health care coverage only (public only); and uninsured. For those aged 65 and over, this 

information was also used to form three mutually exclusive categories: people with Medicare 

and a private plan, people with Medicare who did not have a private plan (but could have other 

sources of coverage such as Medicaid or military coverage), and uninsured. People who only had 

IHS or a single-service plan were considered to be uninsured.
NCHS Data Brief ■ No. 138 ■ December 2013

■  7  ■

Data source and methods

NHIS data are collected continuously throughout the year for NCHS by interviewers from the 

U.S. Census Bureau. NHIS collects information about the health and health care of the civilian 

noninstitutionalized U.S. population. Interviews are conducted in respondents’ homes, but 

follow-ups to complete interviews may be conducted over the telephone. Data from the 2012 

NHIS were used for this analysis. Data on experiences with physician availability were gathered 

from 34,525 adults aged 18 and over who answered questions in the Sample Adult component, 

which collects detailed data from one randomly selected adult (the sample adult). Information 

was also collected on a total of 13,275 children from the Sample Child component of the survey, 

which collects additional data about one randomly selected child (the sample child). For further 

information about NHIS, including the questionnaire, see the NHIS website at http://www.cdc.

gov/nchs/nhis.htm.

NHIS is designed to yield a sample representative of the civilian noninstitutionalized population 

of the United States, and weighting is used to produce national estimates. Data weighting 

procedures are described in more detail elsewhere (6). Point estimates and estimates of 

corresponding variances for this analysis were calculated using SUDAAN software (7) to 

account for the complex sample design of NHIS. The Taylor series linearization method was 

chosen for variance estimation. All estimates shown in this report meet the NCHS standard of 

reliability (relative standard error less than or equal to 30%). Differences between percentages 

were evaluated using two-sided significance tests at the 0.05 level. Terms such as “higher than” 

and “times as likely” indicate statistically significant differences. Terms such as “similar” indicate 

that the statistics being compared were not significantly different. Lack of comment regarding the 

difference between any two estimates does not necessarily suggest that the difference was tested 

and found to be not significant.

About the authors

Renee M. Gindi, Whitney K. Kirzinger, and Robin A. Cohen are with CDC’s National Center for 

Health Statistics, Division of Health Interview Statistics.
NCHS Data Brief ■ No. 138 ■ December 2013

FIRST CLASS MAIL 

POSTAGE & FEES PAID 

CDC/NCHS

PERMIT NO. G-284

For e-mail updates on NCHS publication 

releases, subscribe online at: 

http://www.cdc.gov/nchs/govdelivery.htm.

For questions or general information

about NCHS:

Tel: 1–800–CDC–INFO (1–800–232–4636)

TTY: 1–888–232–6348

Internet: http://www.cdc.gov/nchs

Online request form: http://www.cdc.gov/

cdc-info/requestform.html

ISSN 1941–4927 Print ed.

ISSN 1941–4935 Online ed.

DHHS Publication No. 2014–1209

CS244727

U.S. DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road, Room 5419

Hyattsville, MD 20782

OFFICIAL BUSINESS 

PENALTY FOR PRIVATE USE, $300

References

1. Cohen RA, Martinez ME. Health insurance coverage: Early release of 

estimates from the National Health Interview Survey, 2011. Hyattsville, MD: 

National Center for Health Statistics. 2012. Available from: http://www.cdc.

gov/nchs/data/nhis/earlyrelease/insur201206.pdf.

2. Martinez ME, Cohen RA. Health insurance coverage: Early release of 

estimates from the National Health Interview Survey, January−September 

2012. Hyattsville, MD: National Center for Health Statistics. 2013. Available 

from: http://www.cdc.gov/nchs/data/nhis/earlyrelease/Insur201303.pdf.

3. Hofer AN, Abraham JM, Moscovice I. Expansion of coverage under 

the Patient Protection and Affordable Care Act and primary care utilization. 

Milbank Q 89(1):69–89. 2011.

4. Hing E, Schappert SM. Generalist and specialty physicians: Supply and 

access, 2009–2010. NCHS data brief, no 105. Hyattsville, MD: National 

Center for Health Statistics. 2012. Available from: http://www.cdc.gov/nchs/

data/databriefs/db105.pdf.

5. Access denied: A look at America’s medically disenfranchised. 

Washington, DC: National Association of Community Health Centers and 

The Robert Graham Center. 2007. Available from: http://www.nachc.com/

client/documents/issues-advocacy/policy-library/research-data/researchreports/Access_Denied42407.pdf.

6. Botman SL, Moore TF, Moriarity CL, Parsons VL. Design and 

estimation for the National Health Interview Survey, 1995–2004. National 

Center for Health Statistics. Vital Health Stat 2(130). 2000. Available from: 

http://www.cdc.gov/nchs/data/series/sr_02/sr02_130.pdf.

7. RTI International. SUDAAN (Release 10.0) [computer software]. 2008.

Suggested citation

Gindi RM, Kirzinger WK, Cohen RA. 

Health insurance coverage and adverse 

experiences with physician availability: 

United States, 2012. NCHS data brief, no 

138. Hyattsville, MD: National Center for 

Health Statistics. 2013.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Interview Statistics

Jane F. Gentleman, Ph.D., Director