FACTORS AFFECTING PRIMARY-CARE PHYSICIAN PARTICIPATION IN MEDICARE

OBJECTIVES. This study investigates the levels of participation and th e relative association of economic and noneconomic factors on primary care physician participation in the Medicare program. METHODS. Demogra phic information, participation in Medicare, and attitudes toward both the Medicare program and Medicare patients were collected in a writte n survey mailed to half the primary care physicians in Iowa. Ordinary least squares and logistic regression analyses were conducted to deter mine factors associated with the percentage of Medicare patients in a practice and the acceptance of all new Medicare patients, respectively . RESULTS. TWO thirds of physicians were accepting all new Medicare pa tients, whereas 16% were accepting no new Medicare patients. Factors a ssociated with having a higher percentage of Medica:re patients in a p ractice were as follows: (1) a larger proportion of Medicare recipient s in the county, (2) practice as a general internal medicine physician , (3) more years in practice at the current location, (4) greater enjo yment treating elderly patients, (5) less concern about having too man y Medicare patients, and (6) a stronger belief that the Medicare progr am respects their professional judgment. Physicians less concerned abo ut having too many Medicare patients in their practice and physicians in counties with a higher percentage of Medicare patients were signifi cantly more likely to accept all new Medicare patients. CONCLUSIONS. T hese results suggest that as Medicare reforms are discussed, careful c onsideration of the impact of these reforms on noneconomic issues is i mportant to ensure adequate physician. participation and access for el derly patients through the Medicare program.