More than two-thirds of general internists help uninsured patients financially by reducing their charges or creating a payment plan, according to survey results published Wednesday.
Some 29,500 internists in office-based practice provide about 2.6 million hours of care to uninsured patients each year, says the study, which appears in the November/December issue of the policy journal Health Affairs.
But physicians are less likely to continue to treat uninsured patients because of market pressures from insurance companies, managed care plans, employers and government payers, say the study researchers, led by Gerry Fairbrother of the division of health and science policy at the New York Academy of Medicine.
"Private practitioners provide five times as many visits for the uninsured as do health safety net institutions which would not be able to absorb this number of patients," says Munsey Wheby, M.D., president of the American College of Physicians, in a written statement. "If market forces and policy consequences cause internists and other private practitioners to reduce their care for uninsured patients, there will be nowhere for them to go."
The study is based on a survey of ACP members in private practice about their views on the amount of charity care they provide, their office policies on accepting the uninsured and the characteristics of the uninsured patients they treat.
More than half of the internists say most of their uninsured patients are established patients who have lost their healthcare coverage. The doctors report that they are not able to provide the same level of quality of care for their uninsured patients as for those who are insured. Similarly, the surveyed physicians say continuity of care and their ability to provide medications or specialty referrals is significantly lower for their uninsured patients.