More physicians exiting Medicare fee-for-service: Study

The number of physicians exiting Medicare fee-for-service, or Traditional Medicare, is accelerating, according to a recent study published in JAMA Health Forum.

The study was conducted by health economists Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy at Harvard Medical School and the director of the Healthcare Markets and Regulation  Lab, and Hannah T. Neprash, PhD, associate professor at the University of Minnesota School of Public Health.

They analyzed all Medicare fee-for-service Part B claims from 2010 to 2024, matching them to national provider identifiers. Exits were defined as the absence of any Medicare claims for 12 consecutive months.

Of the over 790,000 physicians who billed Medicare during the period, the number of physicians exiting in any given year increased significantly. Specifically, the rate increased from 1.80% to 3.60%, although rates varied across the study's period. Notably, there was a period of stability from 2014 to 2016 and a spike during the COVID-19 pandemic from 2020 to 2021.

Most recently, the rate of physicians leaving Traditional Medicare started to gradually increase again by 2023 to levels above the 2019 rate.

Additionally, the study found that primary care physicians were more likely to exit Traditional Medicare during the period at 4.41% versus hospital-based specialists at 3.50%, surgical specialists at 2.99% and medical specialists at 2.49%.

The age-adjusted share of primary care physicians exiting Medicare also increased by 0.21 percentage points, outpacing the annual growth in exit rates among other physician types studied.

The COVID-19 pandemic likely accelerated some physicians' exits from Traditional Medicare post-2021, Chernew and Neprash stated in the study. However, multiple factors are likely at play, including greater burdens on physicians because of portal messages and higher demands for clinical documentation.

CMS has also recently reduced Medicare Part B payment rates, which may have contributed to accelerated physician exit rates. The agency recently proposed a base rate hike of 2.5% in 2026 after five consecutive years of cuts.

Still, Chernew and Neprash said lower payment rates cannot explain the period of relative stability between 2014 and 2016.

"Variation in exit rates by specialty suggests that concern about inadequate [primary care physician] supply may be warranted but requires investigation," they concluded.

Jacqueline LaPointe is a graduate of Brandeis University and King's College London. She has been writing about healthcare finance and revenue cycle management since 2016.