Provider participation in Medicare rose 6.3% over 10 years, peaking in 2019

The number of providers participating in Medicare—that is, those that billed the program for patient care services—stood at 622,342 in 2023, marking a 6.3% rise in a decade, a new data analysis published in JAMA revealed.[1] 

However, the number was higher in 2019, just prior to the COVID-19 pandemic, hitting a peak of 626,841 participants. A drop of over 4,200 followed in 2020, coinciding with practice interruptions. 

The study, conducted by a team from public policy research group Rand Corporation and Brown University, analyzed 1.6 billion Medicare fee-for-service claims records, all coming from 960,000 unique physicians. The goal was to chart trends—in particular, the overall number of doctors and advanced patient care practitioners who accepted Medicare patients since 2013. 

What the researchers found was that, while there was some pullback in 2020, and again in 2022, in general the trend went straight up over time, beginning in 2013 when only 585,642 providers submitted a Medicare claim. If not for the COVID-19 pandemic, which caused a peak loss to patient visits in April 2020, it’s not clear if the number of providers participating in Medicare would have dropped at all. 

However, the study authors stopped short of making a firm claim about the impact of the pandemic, opting instead to break down the numbers by sex, age, specialty and location to see if there were any interesting secondary trends. 

They found that female providers were 25% more likely to leave the Medicare program than men. Age was also a factor: As physicians approached Medicare-eligible age themselves, the more likely they were to stop seeing elderly patients covered under the program. Those aged 60 or older in 2013 were nearly six times more likely than the youngest cohort—those under 30—to leave Medicare behind by 2023. 

Further, primary care physicians, as opposed to both medical and surgical specialists, were the most likely to exit. Additionally, those outside metro areas, as opposed to city-based practitioners, were also more likely to stop seeing Medicare patients, regardless of specialty—a data point that concerned the study authors.

“The increased likelihood of Medicare program exits will likely reduce access to care for already underserved communities,” the team, led by Jonathan Cantor, PhD, professor of public policy at Rand, wrote. “As these patient populations already experience more limited access to care, these trends may be associated with adverse health outcomes.”

For context, researchers used a six-month cutoff line for a claims submission to determine when a provider left the program. As they noted, their data was limited to fee-for-service Medicare records—meaning, Medicare Advantage was not factored into any calculation.