Although it was stable in the mid-1990s, the proportion of physicians without any managed care contracts rose from 9.2 percent in 2000–2001 to 11.5 percent in 2004–2005, according to a report by the Center for Studying Health System Change.
"This small, but significant, increase could signal a trend toward greater out-of-pocket costs for patients and a decline in access to physicians," says Paul B. Ginsburg, PhD, president of HSC.
Before we panic, however, Ann S. O'Malley, MD, coauthor of the report, cautions that "despite media reports about doctors dropping out of insurance networks because of payment and administrative hassles, the vast majority of physicians continue to contract with managed care plans."
Other key findings from the report indicate that physicians in solo or two-physician practices are less likely to contract with managed care plans than are larger practices or institution-based practices, perhaps reflecting their higher costs and difficulties with administrative oversight. In addition, physicians in practice for more than 20 years are less likely to contract with plans than those in practice for no more than 10 years. This suggests that experienced physicians may have developed the patient base and reputation that allows them to practice without managed care contracts. About 23 percent of physicians who are in solo or two-physician practices and who are older than 60 (7 percent of all physicians) do not contract with managed care.
Physician contracting and managed care revenue
Physicians with no managed care contracts
Average number of MC contracts for physicians with more than one MC contract
Physicians with no managed care revenue
Percent revenue from managed care for physicians with >= 1% managed care revenue (mean)
*Change from 2000–2001 is statistically significant at p < .001
Source: Community Tracking Study Physician Survey