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Primary Care Still Hard to Get in Massachusetts

MedpageToday

WASHINGTON -- More than half of primary care practices in Massachusetts are not accepting new patients, and wait times for many new patients continue to lengthen five years after the state passed its landmark healthcare reform law, according to a survey sponsored by the state medical society.

"Massachusetts has made great strides in securing insurance coverage for its citizens, but insurance coverage doesn't equal access to care," Alice Coombs, MD, president of the Massachusetts Medical Society, said in a press release. "We still have much work to do to reduce wait times and widen access."

The law passed by Massachusetts in 2006 required all residents to have insurance, and was, in some ways, a model for the national healthcare reform law signed into law last year.

Long wait times persist for new patients making appointments to see an internist or family physician in Massachusetts, the survey found. The average wait time is 48 days for a new patient to see an internist -- five days shorter than last year -- and 36 days to see a family doctor, which is an increase of seven days from 2010.

Just under half (49%) of internists are accepting new patients, which is about the same rate as in 2010.

Fewer than half of family physicians (47%) are accepting new patients, the survey found. When the Massachusetts Medical Society first began collecting data on access to family physicians in 2007, 70% were accepting new patients.

The average wait time for pediatricians was 24 days, the same as last year, and about three-quarters of pediatricians practicing in Massachusetts are accepting new patients, down slightly from last year when 80% were accepting new patients.

The long wait times might drive people to seek more costly care in the state's emergency rooms, Coombs said.

The wait times to see specialists, including gastroenterologists, Ob/Gyns, orthopedic surgeons, and cardiologists, all increased from last year. Still, the wait times don't compare to those for seeing a primary care doctor, and access to specialists is much easier since the vast majority of specialists are accepting new patients.

For the first time, the survey collected data on what types of insurance various specialities accept and don't accept, and found that the physicians less likely to accept new patients -- internists and family physicians -- also were less likely to accept MassHealth -- the state's plan for the poor -- and Commonwealth Choice plans, which are sold in a marketplace similar to how the health exchanges mandated under the Affordable Care Act (ACA) will operate.

While most internists (85%) and family physicians (87%) accept Medicare, just about half of internists and 62% of family physicians accept MassHealth, and even fewer accept Commonwealth Care.

The majority of specialists accept Medicare and MassHealth, the report said.

The survey of 838 physician offices was conducted on behalf of the medical society by Anderson Robbins Research. The firm called randomly selected offices between Feb. 16 and March 8, 2011, and asked to schedule an appointment for a new patient. Nonemergency reasons were given for the appointments in order to measure wait times for routine care.

Primary Source

The Massachusetts Medical Society

Massachusetts Medical Society "2011 Patient Access to Health Care Study."