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How Many Doctors Have Declined Participation in the Medicare Program?

The number of physicians who have opted out of accepting Medicare payments has held steady
in the latest report released by the Kaiser Family Foundation. Of all non-pediatric physicians, 1.1
percent – or 11,039 – have opted out in 2023.
“This analysis shows that a very small share of non-pediatric physicians are opting-out of
Medicare, similar to prior analyses dating back to 2013,” KFF wrote in its Sept. 11 report.
“Notably, psychiatrists have the highest opt-out rates and are disproportionately represented
among physicians who have opted out of Medicare in 2023.”
Among the highlights of the findings:

  • The number of physicians who opt out is considered a very low threshold. In fact, the number
    has not been statistically different over the past decade.
  • Among specific practices, psychiatrists make up a disproportionate number of physicians who
    choose not to accept Medicare. According to the data, 7.7 percent of psychiatrists opt-out.
  • There are four states where more than 2% of physicians opt out of accepting Medicare. Those
    are Alaska (3.1%), Colorado (2.3%), Wyoming (2.3%), Idaho (2.1%), and the District of Columbia
    Among the reasons KFF cites from such a small Medicare opt-out number is the aging
    population of the United States, which means there’s a larger patient base that uses Medicare
    for health insurance.
    “The aging of the U.S. population, and consequently, the increase in number of Medicare
    beneficiaries, means that for many physicians, older adults with Medicare coverage account for
    a relatively large share of the patient population and revenues,” KFF wrote. “For these
    physicians, the loss of revenue resulting from opting out of Medicare would be substantial,
    notwithstanding the difference in payment rates between Medicare and private insurance or
    In July, the Centers for Medicare & Medicaid Services (CMS) released its annual public rule,
    announcing and soliciting public comments on changes for Medicare payments under the
    Physician Fee Schedule, including Medicare Part B issues.
    Last week, the American Medical Association came out swinging against what it says amounts to
    a 3.36% cut in the proposed 2024 Medicare physician pay schedule.
    “With higher costs for everything associated with practicing medicine, another year of Medicare
    payment cuts jeopardizes patient access and imperils the physician practices on which
    communities rely,” AMA President Jesse M. Ehrenfeld, MD, MPH, said in a release from the
    According to the numbers cited by the Center for Medicare Advocacy, more than 65 million
    people were enrolled in Medicare as of March 2023, which is an increase of nearly 100,000
    people from data released in September 2022. Those numbers break out this way:
  • 33.9 million are enrolled in Original Medicare
  • 31.8 million are enrolled in Medicare Advantage or other health plans. This number includes
    enrollment in Medicare Advantage plans with and without prescription drug coverage.
  • 51.6 million are enrolled in Medicare Part D, including enrollment in stand-alone prescription
    drug plans as well as Medicare Advantage plans that offer prescription coverage.