How To Solve This: Physician Exits From Medicare Increased in Vulnerable Areas

[GailL1]

Source: MedPage Today.com - 10/20/2025 - Physician Exits From Medicare Increased in Vulnerable Areas 

This is a real problem - How do you encourage medical providers to set up shop and stay in vulnerable areas of our country?  How should we encourage them to continuously accept Medicare (or Medicare and Medicaid [dual eligibles]) especially since the numbers of beneficiaries are growing exponentially.

Maybe we need to pay them  more - especially those who choose to locate in these medical deserts -

Perhaps those beneficiaries who live in urban or metro areas should subsidize those in rural setting MORE. 

We already have program to try to entice them to these underserved areas but their long ranch goals of their careers just does no materialize.  

What good is it to have a rural hospital or clinic, if there are not enough medical doctors to staff them and treat the patients - especially those on Medicare (or Medicare and Medicaid).  

excerpts from the article:  

Key TakeAWays

• From 2013 to 2023, the proportion of physicians in the Medicare program grew by 6.3%.
• However, physicians living in nonmetropolitan versus metropolitan counties were more likely to exit the Medicare program, as were physicians living in Health Professional Shortage Areas.
• Despite the attention to physician burnout during the COVID pandemic, overall exit trends were not as high as expected.

The number of physicians serving Medicare patients grew from 2013 to 2023, but program exit rates in rural and underserved areas increased, according to an analysis of Medicare claims data.

There certainly was an increase in physicians leaving the workforce during COVID ... but [it is] not substantially different from what we've seen in the pre-COVID period," he noted, adding that this was a "little surprising."

However, the "much larger increase" in exit rates in HPSA and rural markets is concerning, he said.

The authors also found that physicians who were female, older, and working in primary care were more likely to exit the program versus their counterparts.

He pointed out that the rate of physicians leaving Medicare in the study more than doubled over a decade, with one in nearly 20 physicians deciding not to treat Medicare beneficiaries in 2023.

The total number of participating physicians grew, but the number of Medicare beneficiaries also grew by 27% over the same period, according to CMS dataopens in a new tab or window. "That means there are 16% fewer physicians per beneficiary now than a decade ago," noted Miller, who was not involved in this study.

[SereneSeagull]

Paying more.  I’d use the same answer for teachers in low income areas as well.  
can’t retain good teachers.  Burn out and underpaid

[GailL1]

@SereneSeagull 

Sometimes money isn’t everything.  Think about it -

A young doctor begins their practice in some rural location; maybe they buy their practice from some older doc who is retiring.  

What are they actual getting into - 

• a practice that has more low paying beneficiaries - Medicaid, Medicare or Medicare and Medicaid, including CHIPS. 
• not only are these the lowest paying methods for care, they often are extremely restrictive in the care that is received.  
• The medical infrastructure is also lacking - no vendors to do lab work, no free standing imaging or the same treatment centers. 
• Maybe the local hospital could take up some of the infrastructure problems but they cannot do it all - plus they expect a payment (larger) as a hospital rendering care than a vendor to run labs or a diagnostic test.  
• Who should pay for the added cost?  Maybe those in more urban areas should pay.  Maybe we stop building labs and imaging centers or even women’s centers in urban areas and build them in more rural areas - a population that perhaps can drive further for their care.

What then happens when the young doc decides to want more - a family of their own, better professional advantages; the place where their practice is now located definitely does not support advantacement.  Probably pretty similar with teachers.

Now think about it when we say “rural”  - we aren’t always talking about a picturesque area where everybody in town knows everybody else in town.  We maybe talking about a town of 200 with the next closest town 200 miles away is also a town of 200.  

I am a proponent of a more local government dealing with problems like these - so yes, block grants and then monitor to keep down the graft of the few taking advantage in some monetary way.  

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