Kansas ranks near bottom in percent of doctors taking Medicare; Missouri near the top
About 86 percent of Missouri doctors accept all Medicare plans, one of the highest rates in the nation. But across the state line, Kansans face one of the lowest rates of acceptance, according to a new survey.
With open enrollment for Medicare plans starting this week, the survey provides a strong reminder that people need to check what plans their doctors participate in before they sign up.
Open enrollment is the one time of the year when everyone on Medicare can choose to switch from the traditional government-run plan to one of the privatized Medicare Advantage plans, or from one Advantage plan to another.
A 2017 study showed the Advantage plans “tended to pay physicians less” than traditional Medicare, which could affect whether doctors take them.
The survey of 8,774 physicians by health care firm Merritt Hawkins found wide disparities from state to state in percentage of doctors who take all Medicare plans.
Missouri ranked sixth in the country, while Kansas ranked 48th at 70.6 percent.
Travis Singleton, an analyst with Merritt Hawkins, said there are several possible reasons for the big difference between Kansas and Missouri.
Even within the traditional Medicare program, payment rates to medical providers differ some based on geography, cost of living and other variables.
“There’s a lot of different factors that go into it, in true government style,” Singleton said.
Singleton said the distribution of doctors in both states might also explain the difference.
Overall Missouri has more physicians per capita, according to the Association of American Medical Colleges, but Singleton said they’re more concentrated in major metro areas like Kansas City and St. Louis. That means they have to compete against one another for patients and can’t turn away Medicare. Rural doctors practicing in shortage areas could theoretically be more choosy, but rural populations have higher rates of Medicare and Medicaid coverage, so turning away those plans might not be an option.
Because of competition among medical providers, the differences in Medicare acceptance rates likely would be less pronounced in the Kansas City area.
John Hagan, past president of the Kansas City Medical Society, said the number of doctors employed by hospital systems may also play a role. More Missouri physicians in big cities now work for hospitals that take all Medicare patients.
“I have known physicians that sold their practices to hospitals, the hospital doubled the charges the doctors were making when self-employed and the doctors get more pay, as does the hospital, because Medicare strongly favors hospitals,” Hagan said.
Rep. John Eplee, a family physician from Atchison who serves in the Kansas Legislature, said his state also has more physician assistants, and that could explain the difference between the states.
“I think a lot of these elderly people are being taken care of by mid-levels (in Kansas),” said Eplee, adding that he himself has long employed two physician assistants, “rather than MDs (medical doctors) and DOs (doctors of osteopathy).”
This story was originally published October 15, 2018 at 1:53 PM.