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Supplementary Table 4
Community Level Access Measures

Note:This table shows five key measures of access at the community level for Medicare and the privately insured. These measures include 1) the proportion of physicians reporting that they are willing to accept all new patients; 2) the proportion of physicians reporting that they are accepting no new patients; 3) the proportion of Medicare seniors and older privately-insured people (ages 50-64) who report not getting or putting off care for any reason; 4) the proportion of Medicare seniors and older privately-insured people who report a wait of over 3 weeks for a checkup; and 5) the proportion of Medicare seniors and older privately-insured people who report a wait of over 1 week for an illness appointment.

These data illustrate that access to care within a community cannot be captured by a single measure such as the proportion of physicians accepting new Medicare patients. Given the complexity of health care markets, anticipating and monitoring access problems resulting from Medicare physician payment rate cuts is challenging. Access for Medicare beneficiaries could deteriorate substantially in some markets, but fail to be identified by national indicators. Furthermore, access problems within a market may occur for both Medicare and private populations. In addition, surveys of a single stakeholder, such as physicians, may not give the full picture

Community Medicare Privately-Insured
  1997 1999 2001 1997 1999 2001
Physicians Accepting All New Patients1
Boston
76.9%
76.8%
69.8%*
76.2%
79.0%
70.8%
Cleveland
76.0
75.1
71.5
73.7
77.9
76.0
Greenville
67.8
64.9
68.5
71.9
72.5
79.2*
Indianapolis
71.8
69.6
62.9*
75.1
66.9
64.0*
Lansing
60.8
63.1
67.2
65.1
57.0
70.5
Little Rock
66.1
71.4
65.8
75.7
75.1
75.1
Miami
67.0
60.7
58.0*
63.4
66.3
61.6
Northern New Jersey
63.8
60.1
69.4
67.8
67.3
69.0
Orange County, Calif.
63.0
63.8
63.3
68.8
70.2
64.9
Phoenix
65.5
61.7
61.1
71.1
67.6
62.9*
Seattle
71.3
62.2
54.5*
70.6
69.2
61.8*
Syracuse
70.1
66.1
67.5
69.0
64.3
69.1
Physicians Accepting No New Patients1
Boston
7.5%
6.3%
7.4%
2.2%
1.3%
3.6%
Cleveland
7.2
7.3
7.1
2.1
3.6
2.9
Greenville
12.2
12.5
10.2
3.0
3.2
2.1
Indianapolis
8.6
10.8
11.9
1.1
2.9
3.7*
Lansing
11.6
8.8
7.3
4.6
3.2
2.0*
Little Rock
13.4
7.8
11.5
1.2
3.3
4.3*
Miami
9.2
13.4
15.4*
5.2
5.4
6.8
Northern New Jersey
10.7
13.6
7.7
3.4
4.5
3.9
Orange County, Calif.
10.5
12.3
8.6
2.7
4.1
5.0
Phoenix
10.3
8.0
10.5
4.4
3.8
5.6
Seattle
5.7
7.3
12.7*
2.3
2.6
4.1
Syracuse
8.6
12.4
12.9
2.1
4.3
3.9
 
Community Medicare Privately-Insured (Ages 50-64)
  1997 1999 2001 1997 1999 2001
People Reporting Not Getting or Putting Off Care for Any Reason2
Boston
8.9%
10.2%
6.8%
21.2%
18.4%
19.8%
Cleveland
13.2
11.1
15.3
19.8
21.0
17.6
Greenville
11.7
15.2
13.0
17.9
17.6
16.8
Indianapolis
13.9
9.1
15.1
16.4
20.0
20.8
Lansing
10.8
12.9
13.2
22.3
23.9
19.2
Little Rock
15.4
15.3
13.6
24.4
26.4
20.4
Miami
15.0
11.4
15.6
23.4
19.2
26.2
Northern New Jersey
14.5
14.8
11.6
17.6
17.3
19.6
Orange County, Calif.
13.9
15.5
15.5
25.0
23.4
23.5
Phoenix
14.3
17.2
15.3
23.3
26.5
20.5
Seattle
11.2
9.4
7.6
21.9
24.1
24.3
Syracuse
9.6
8.2
11.6
16.3
16.6
18.2
Delay for Checkup Appointment Exceeds 3 Weeks2
Boston
61.9%
49.5%
54.6%
53.5%
53.4%
56.0%
Cleveland
31.8
42.3
39.3
28.2
39.5
48.0*
Greenville
40.9
43.7
48.7
34.8
39.2
42.2
Indianapolis
42.4
37.8
46.4
29.5
30.9
44.2*
Lansing
43.8
36.6
43.0
33.5
43.1
51.6*
Little Rock
29.9
26.7
39.0
28.5
34.4
37.0
Miami
23.6
22.8
38.5*
19.7
13.9
24.9
Northern New Jersey
39.7
41.0
40.1
32.4
30.8
28.4
Orange County, Calif.
28.1
34.0
25.4
31.0
28.2
30.6
Phoenix
23.4
32.6
29.5
24.7
31.8
33.4
Seattle
16.4
27.1
24.2
22.7
27.8
26.3
Syracuse
49.7
53.5
56.4
44.3
51.3
56.7
Delay for Illness Appointment Exceeds 1 Week2
Boston
71.1%
70.8%
70.4%
57.7%
61.7%
58.0%
Cleveland
50.6
71.5
60.1
54.4
47.8
50.8
Greenville
51.2
57.6
61.1
39.5
52.3
51.4
Indianapolis
49.0
65.0
60.9
40.0
33.5
52.8
Lansing
49.8
45.9
61.2
47.3
55.6
49.3
Little Rock
49.0
46.8
55.8
40.7
42.2
48.0
Miami
52.7
65.6
53.3
47.1
52.1
58.6
Northern New Jersey
56.5
55.7
64.8
45.1
46.1
46.8
Orange County, Calif.
49.3
40.6
55.1
43.7
43.8
52.9
Phoenix
45.6
66.0
44.6
44.6
43.9
59.9*
Seattle
44.6
50.3
55.0
33.0
50.0
45.1
Syracuse
54.5
53.9
53.4
53.0
52.2
56.1
* Indicates change from 1997 to 2001 is statistically significant at p<.05.

Sources:
1 From the Community Tracking Study Physician Survey
2 From the Community Tracking Study Household Survey

Note: For presentation, this table refers to a single calendar year of the Household and Physician Surveys.
 

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