Publications · 2026
Medicare Appointment Availability and Wait Times Vary Considerably Across Four Large US Urban Markets
Health Affairs Scholar , 4(3) , 2026 · doi:10.1093/haschl/qxag054
Overview
We posed as new Medicare patients calling 444 primary care clinics across Chicago, Los Angeles, New York, and Portland to measure who could actually get an appointment. Acceptance ranged from 97% in Los Angeles to just 35% in Portland, with median wait times spanning 8 to 61 days. Larger multi-site practices and hospital-system-affiliated clinics were the least accessible, suggesting that consolidation may be reshaping primary care access in ways that warrant closer policy attention.
Abstract
INTRODUCTION: Timely access to primary care is essential for Medicare beneficiaries. Amid growing workforce shortages and consolidation, little is known about whether and how organizational and market-level factors affect access. METHODS: We conducted a simulated-patient study of 444 primary care clinics in Chicago, Los Angeles, New York, and Portland to measure acceptance of new Medicare patients and wait times to the earliest appointment. RESULTS: Overall, 77.5% of clinics accepted new Medicare patients, ranging from 96.9% in Los Angeles to just 35.0% in Portland. Among accepting clinics, median wait times for a physician varied from 8 days in New York City to 61 days in Portland. In adjusted analyses, each additional practice site was associated with a 1.5-percentage-point lower probability of accepting new Medicare patients (P < 0.001), and hospital or health system-affiliated practices had waits about 15 days longer than independent practices, with prolonged delays concentrated in Portland. CONCLUSIONS: Findings highlight the importance of local organizational structure and market context in shaping access, with implications for workforce planning and access monitoring.
Recognition & impact
Topics
- Medicare
- primary care access
- audit study
- secret shopper
- health system consolidation
- wait times
- industrial organization
- health services research
How to cite
Beetham T, Marsh T, Barnett ML, Aaron RM, Greenberg E, Do Alexandra, Zhu JM. Medicare Appointment Availability and Wait Times Vary Considerably Across Four Large US Urban Markets. Health Affairs Scholar, 4(3); 2026. doi:10.1093/haschl/qxag054
Show BibTeX
@article{beetham2026medicareappointment,
title = {{Medicare Appointment Availability and Wait Times Vary Considerably Across Four Large US Urban Markets}},
author = {Beetham, T. and Marsh, T. and Barnett, M. L. and Aaron, R. M. and Greenberg, E. and Do Alexandra and Zhu, J. M.},
journal = {Health Affairs Scholar},
year = {2026},
volume = {4},
number = {3},
doi = {10.1093/haschl/qxag054},
url = {https://doi.org/10.1093/haschl/qxag054},
abstract = {INTRODUCTION: Timely access to primary care is essential for Medicare beneficiaries. Amid growing workforce shortages and consolidation, little is known about whether and how organizational and market-level factors affect access. METHODS: We conducted a simulated-patient study of 444 primary care clinics in Chicago, Los Angeles, New York, and Portland to measure acceptance of new Medicare patients and wait times to the earliest appointment. RESULTS: Overall, 77.5% of clinics accepted new Medicare patients, ranging from 96.9% in Los Angeles to just 35.0% in Portland. Among accepting clinics, median wait times for a physician varied from 8 days in New York City to 61 days in Portland. In adjusted analyses, each additional practice site was associated with a 1.5-percentage-point lower probability of accepting new Medicare patients (P < 0.001), and hospital or health system-affiliated practices had waits about 15 days longer than independent practices, with prolonged delays concentrated in Portland. CONCLUSIONS: Findings highlight the importance of local organizational structure and market context in shaping access, with implications for workforce planning and access monitoring.},
keywords = {Medicare; primary care access; audit study; secret shopper; health system consolidation; wait times; industrial organization; health services research},
note = {Media coverage: Willamette Week, KOIN Portland}
}