Factors Associated with the Acceptance of New TRICARE and Medicare Patients by Health Care Providers
*Names in bold indicate Presenter
We address two main research questions: (1) how the acceptance rate for new TRICARE Standard patients compares to the acceptance rate for new Medicare patients, separately for primary care providers, specialists, and mental health providers; and (2) what provider and local-area characteristics are associated with the decision to accept each insurance type.
We use data from the TRICARE Standard Survey of Providers, which was administered to a nationally representative sample of civilian physicians and non-physician mental health providers from 2012 to 2015. Among other questions, providers were asked whether they accept any new patients, new TRICARE Standard patients, or new Medicare patients. The data also include information about the characteristics of the providers, such as their specialization, practice type, and age. In addition, we incorporate data from the American Community Survey to measure local area characteristics, such as the number of providers per 1,000 residents and per capita income.
We first present descriptive statistics showing the mean acceptance rate of TRICARE Standard and Medicare by provider characteristics to provide a baseline for how TRICARE Standard and Medicare acceptance rates differ and which types of providers are most likely to accept each type of insurance. Providers that do not accept these insurance sources are asked for an explanation; we provide a summary of the most frequently mentioned responses to add context for the relatively low acceptance rates by certain providers.
We then use a nested logit model to estimate the relationships between provider and local area characteristics and insurance acceptance decisions. The outcomes we analyze are whether providers accept any new patients, and if they do accept new patients, if they accept: (1) both new TRICARE Standard and new Medicare patients; (2) new TRICARE Standard but not new Medicare patients; (3) new Medicare patients but not new TRICARE Standard patients; or (4) no new patients from either TRICARE Standard or Medicare. Our findings will provide insight into the challenges and opportunities associated with attempts at improving the acceptance rate of TRICARE Standard and Medicare.