How Many Physicians Have Opted Out of the Medicare Program?

How Many Physicians Have Opted Out of the Medicare Program?

Nancy Ochieng and Gabrielle Clerveau
Published: Sep 11, 2023

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Medicare provides health insurance coverage to 65 million adults—nearly 20% of the U.S. population—and is a major source of revenue for providers, including physicians and other clinicians. In 2022, Medicare spending on Part B services (including physician services, outpatient services, and physician-administered drugs) accounted for nearly half (48%) of total Medicare benefit spending, and this share is expected to grow to more than half (52%) by 2032. Physicians are not required to participate in Medicare, though the vast majority of them choose to do so.

Every year, the Centers for Medicare and Medicaid Services (CMS) updates Medicare payments to physicians under the physician fee schedule through rulemaking, as required under law. Over the years, some have raised concerns that physicians would opt out of Medicare because Medicare payments for physician services are lower, on average, than payments from private insurers, potentially leading to a shortage of physicians willing to treat people with Medicare.

This brief builds on previous KFF analyses by providing the most recent data on the extent to which non-pediatric physicians are opting out of Medicare, by specialty and by state, in 2023, based on data published by CMS as of June 2023.

source: KFF