NCHS Data Brief ■ No. 195 ■ March 2015

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Acceptance of New Patients With Public and Private 

Insurance by Office-based Physicians: 

United States, 2013

Esther Hing, M.P.H.; Sandra L. Decker, Ph.D.; and Eric Jamoom, Ph.D., M.P.H., M.S.

Key findings 

Data from the 2013 

National Electronic Health 

Records Survey

● In 2013, most office-based 

physicians (95.3%) were 

accepting new patients.

● The percentage of physicians 

accepting new Medicaid 

patients (68.9%) was lower 

than the percentage accepting 

new Medicare (83.7%) or 

new privately insured (84.7%) 

patients.

● The percentage of physicians 

accepting new Medicaid 

and Medicare patients was 

lower for physicians within 

metropolitan statistical areas 

(MSAs) compared with 

physicians outside of MSAs.

● The percentage of physicians 

who accepted new privately 

insured, Medicare, and 

Medicaid patients each varied 

by state.

Physician acceptance of new Medicaid patients has shown to be lower than 

acceptance of new Medicare patients or new privately insured patients (1). 

Acceptance of new Medicaid patients also has shown to be lower in states 

with lower Medicaid payment rates to physicians (2). Using the 2013 National 

Electronic Health Records Survey (NEHRS), this report summarizes physician 

acceptance of new patients with Medicaid, Medicare, and private insurance. 

It also summarizes information on how these acceptance rates vary by select 

physician characteristics and by state.

Keywords: Medicaid • Medicare • National Electronic Health Records Survey

How did acceptance of new patients by office-based 

physicians vary by the patient’s source of payment?

● In 2013, 95.3% of physicians were accepting new patients (Figure 1). 

● The percentage of physicians accepting new privately insured patients 

(84.7%) was greater than the percentage accepting new Medicaid 

patients (68.9%).

Figure 1. Office-based physicians accepting new patients, by patient source of payment:

United States, 2013

1

Difference from percentage accepting new Medicaid patients is statistically significant (p < 0.05). 2

Excluding pediatricians, the percentage of physicians accepting new Medicare patients is 88.8%.

SOURCE: CDC/NCHS, National Electronic Health Records Survey. 

68.9

83.7

84.7

95.3

0 20 40 60 80 100

Medicaid

Medicare1,2

Private insurance1

Accepts new patients

Percent of physicians
NCHS Data Brief ■ No. 195 ■ March 2015

■  2  ■

● The percentage of physicians accepting new Medicare patients (83.7%) was also greater 

than the percentage accepting new Medicaid patients.

Did acceptance of new patients by office-based physicians differ by 

metropolitan status? 

● Within metropolitan statistical areas (MSAs), the percentage of physicians accepting new 

privately insured patients (84.6%) was greater than the percentage accepting new Medicaid 

patients (67.2%) (Figure 2).

● The percentage of physicians accepting new Medicare patients was higher than the 

percentage accepting new Medicaid patients both within and outside of MSAs.

● The percentage of physicians accepting new Medicare patients was lower within MSAs 

(82.9%) compared with those outside of MSAs (91.2%).

● The percentage of physicians accepting new Medicaid patients (67.2%) was also lower 

within MSAs compared with those outside of them (85.7%).

Figure 2. Office-based physicians accepting new patients, by patient payment source and metropolitan status: 

United States, 2013 Percent of physicians

1

Within MSAs, the percentage of physicians accepting new privately insured patients is significantly greater than the percentage of physicians accepting new 

Medicaid patients (p < 0.05). 2

Percentage of physicians accepting new Medicaid patients is lower than the percentage accepting new Medicare patients both inside and outside of MSAs

(p < 0.05). 3

Difference by metropolitan status is statistically significant (p < 0.05).

NOTE: MSA is metropolitan statistical area.

SOURCE: CDC/NCHS, National Electronic Health Records Survey.

84.6 82.9

67.2

85.8

91.2

85.7

0

10

20

30

40

50

60

70

80

90

100

Private insurance1 Medicare2,3 Medicaid3

MSA Non-MSA
NCHS Data Brief ■ No. 195 ■ March 2015

■  3  ■

Did acceptance of new privately insured patients by office-based 

physicians differ by state?

● In 2013, the percentage of physicians who accepted new privately insured patients varied 

from 67.1% in the District of Columbia (DC) to 95.1% in Illinois (Figure 3).

● In 2013, the percentage of physicians who accepted new privately insured patients was 

significantly higher than the national average (84.7%) in eight states (Arkansas, Illinois, 

Minnesota, Nebraska, New Hampshire, Oklahoma, West Virginia, and Wyoming).

● In 2013, only DC had a significantly lower percentage of physicians accepting new privately 

insured patients (67.1%) compared with the national average.

Figure 3. Percentage of office-based physicians accepting new privately insured patients, by state: United States, 2013

SOURCE: CDC/NCHS, National Electronic Health Records Survey. 

OR

84.0

CA

76.6

AZ

87.9

AK

85.4

HI

75.0

NM

90.8

TX

80.6

LA

86.5

MS

84.9

AL

76.4

GA

81.7

OH

88.7

FL

84.7

AR

91.9

MO

87.0

TN

84.2

KY

83.6

NE

91.3

OK

94.1

KS

86.2

NV

84.3 UT

85.8 CO

85.4

WA

85.2

ID

88.0

MT

85.8

ND

87.8

WY

91.5

SD

87.0

WI

89.5 MI

81.4

ME

85.8

NH

91.8

VT

85.6

NY

80.1

PA

89.8

WV

91.9

VA

85.4

MA

83.0

CT

90.6

RI

78.0

NJ

87.5

DE

86.8

DC

67.1

MD

81.8

NC

89.7

SC

79.0

IN

87.0

IL

95.1

MN

94.9

IA

89.4

Significantly higher than national average

Not significantly different from national average

Significantly lower than national average National average is 84.7%.
NCHS Data Brief ■ No. 195 ■ March 2015

■  4  ■

Did acceptance of new Medicare patients by office-based physicians differ 

by state? 

● In 2013, the percentage of physicians who accepted new Medicare patients ranged from 

75.5% in Hawaii to 95.2% in North Dakota (Figure 4).

● The percentage of physicians who accepted new Medicare patients was significantly higher 

than the national average (83.7%) in seven states (Minnesota, Nebraska, New Hampshire, 

North Dakota, Pennsylvania, South Dakota, and Wyoming).

● Compared with the national average, no state had a significantly lower percentage of 

physicians accepting new Medicare patients.

Figure 4. Percentage of office-based physicians accepting new Medicare patients, by state: United States, 2013

SOURCE: CDC/NCHS, National Electronic Health Records Survey. 

OR

76.3

CA

77.2

AZ

88.9

AK

81.8

HI

75.5

NM

86.9

TX

79.9

LA

83.5

MS

84.1

AL

84.0

GA

80.0

OH

87.7

FL

88.4

AR

88.7

MO

84.4

TN

84.3

KY

87.1

NE

93.0

OK

86.0

KS

84.7

NV

80.8 UT

87.5 CO

81.0

WA

77.7

ID

85.9

MT

87.9

ND

95.2

WY

89.9

SD

92.2

WI

89.1 MI

85.5

ME

84.9

NH

94.5

VT

84.0

NY

77.5

PA

90.5

WV

89.7

VA

79.2

MA

79.4

CT

86.1

RI

87.1

NJ

82.6

DE

81.5

DC

76.1

MD

NC 81.9

83.4

SC

85.5

IN

89.6

IL

88.7

MN

94.1

IA

85.7

Significantly higher than national average

Not significantly different from national average National average is 83.7%.
NCHS Data Brief ■ No. 195 ■ March 2015

■  5  ■

Did acceptance of new Medicaid patients by office-based physicians differ 

by state? 

● In 2013, the percentage of physicians who accepted new Medicaid patients ranged from 

38.7% in New Jersey to 96.5% in Nebraska (Figure 5).

● The percentage of physicians who accepted new Medicaid patients was significantly lower 

than the national average of 68.9% in five states: California (54.2%), Florida (55.9%), 

Louisiana (56.8%), New Jersey (38.7%), and New York (57.1%).

● The percentage of physicians accepting new Medicaid patients was significantly higher than 

the national average in 25 states.

Figure 5. Percentage of office-based physicians accepting new Medicaid patients, by state: United States, 2013

SOURCE: CDC/NCHS, National Electronic Health Records Survey. 

OR

77.2

CA

54.2

AZ

70.1

AK

89.9

HI

68.3

NM

93.3

TX

57.6

LA

56.8

MS

83.2

AL

67.5

GA

71.9

OH

79.0

FL

55.9

AR

89.8

MO

70.2

TN

75.6

KY

83.0

NE

96.5

OK

78.8

KS

64.6

NV

78.9 UT

77.2 CO

70.4

WA

71.3

ID

86.8

MT

90.0

ND

96.2

WY

93.9

SD

94.4

WI

88.2 MI

69.6

ME

79.8

NH

88.2

VT

83.2

NY

57.1

PA

81.0

WV

82.5

VA

70.0

MA

76.0

CT

72.5

RI

71.0

NJ

38.7

DE

80.0

DC

68.5

MD

65.7 NC

80.1

SC

72.3

IN

85.8

IL

73.2

MN

94.1

IA

89.6

Significantly higher than national average

Not significantly different from national average

Significantly lower than national average National average is 68.9%.
NCHS Data Brief ■ No. 195 ■ March 2015

■ 6  ■

Summary

In 2013, most office-based physicians (95.3%) accepted new patients. The percentage of 

physicians accepting new Medicaid patients (68.9%) was lower than the percentage accepting 

new Medicare patients (83.7%) or new privately insured patients (84.7%). The percentage of 

physicians accepting new Medicare or Medicaid patients was lower for physicians within MSAs 

compared with those outside of MSAs. For example, only 67.2% of physicians within MSAs 

accepted new Medicaid patients compared with 85.7% of physicians outside of these areas. By 

state, the percentage of physicians who accepted new Medicaid patients ranged from 38.7% in 

New Jersey to 96.5% in Nebraska.

One provision of the Affordable Care Act called for Medicaid payment rates for some primary 

care services provided by primary care physicians to equal Medicare rates with full federal 

financing in 2013 and 2014 (3). This payment change is expected to greatly increase Medicaid 

payment rates in some states where rates were well below Medicare rates (4). However, many 

states experienced delays in implementing payment increases, which meant that most states 

had not implemented the payment increases by the time NEHRS was fielded in early 2013 (5). 

Data from 2014 will be needed to determine if physician acceptance of new Medicaid patients 

increased.

Definition

Acceptance of new patients: Physicians in NEHRS were asked if they accepted any new patients. 

Those who accepted new patients were questioned about which payment sources they accepted. 

Those who accepted no new patients were considered not to accept privately insured patients or 

those with Medicare or Medicaid.
NCHS Data Brief ■ No. 195 ■ March 2015

■ 7  ■

Data sources and methods

Data for this report come from NEHRS, which is conducted by the Centers for Disease 

Control and Prevention’s National Center for Health Statistics (NCHS) as an annual, nationally 

representative survey of office-based physicians affiliated with the National Ambulatory 

Medical Care Survey. The survey is funded by the Office of the National Coordinator for Health 

Information Technology. The target universe consists of physicians classified as providing 

direct patient care in office-based practices. Radiologists, anesthesiologists, and pathologists are 

excluded. The survey was conducted from February 2013 through June 2013. The unweighted 

response rate was 70% (67% weighted). A copy of the survey is available from the NCHS 

website (6). The unweighted percentage of physicians not providing information on acceptance of 

patients with private insurance, Medicare, and Medicaid was 2.5%, 5.1%, and 6.9%, respectively. 

Analyses in this report were based on a responding sample of 4,220 physicians after excluding 

430 physicians (9%) missing information on acceptance of new Medicaid, Medicare, or privately 

insured patients.

Physicians’ updated information on practice location was used to generate state-level estimates. 

Statements of differences in estimates are based on two-tailed t tests with significance at the 

p < 0.05 level. Data analyses incorporate survey weights and standard errors that accounted for 

the complex design of NEHRS using the statistical packages SAS version 9.2 (SAS Institute, 

Cary, N.C.) and SUDAAN version 10.0 (RTI International, Research Triangle Park, N.C.)

About the authors

Esther Hing is with CDC’s National Center for Health Statistics (NCHS), Division of Health 

Care Statistics; Sandra L. Decker is with NCHS’ Office of Analysis and Epidemiology; and 

Eric Jamoom is with the Division of Health Care Statistics.
NCHS Data Brief ■ No. 195 ■ March 2015

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References

1. Decker SL. In 2011 nearly one-third of physicians said they would 

not accept new Medicaid patients, but rising fees may help. Health Aff 

(Millwood) 31(8):1673–9. 2012.

2. Decker SL. Medicaid physician fees and the quality of medical care of 

Medicaid patients in the USA. Rev Econ Househ 5(1):95–112. 2007.

3. Patient Protection and Affordable Care Act. Pub L No 111–148, 124 Stat 

119, 132. 2010.

4. Zuckerman S, Goin D. How much will Medicaid physician fees for 

primary care rise in 2013? Evidence from a 2012 survey of Medicaid 

physician fees. 2012. Available from: https://kaiserfamilyfoundation.files.

wordpress.com/2013/01/8398.pdf.

5. Kaiser Commission on Medicaid and the Uninsured. Increasing Medicaid 

primary care fees for certain physicians in 2013 and 2014: A primer on 

the health reform provision and final rule. 2012. Available from: http://

kaiserfamilyfoundation.files.wordpress.com/2013/01/8397.pdf.

6. NCHS. National Electronic Health Records Survey 2013. 2013. Available 

from: http://www.cdc.gov/nchs/data/ahcd/2013_NEHRS_Questionnaire.pdf.

Suggested citation

Hing E, Decker SL, Jamoom E. Acceptance 

of new patients with public and private 

insurance by office-based physicians: United 

States, 2013. NCHS data brief, no 195. 

Hyattsville, MD: National Center for Health 

Statistics. 2015.

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., M.B.A., Director

Nathaniel Schenker, Ph.D., Deputy Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Care Statistics

Clarice Brown, M.S., Director

Office of Analysis and Epidemiology

Irma E. Arispe, Ph.D., Director

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