TY  - JOUR
TI  - Medicare Appointment Availability and Wait Times Vary Considerably Across Four Large US Urban Markets
AU  - Beetham, T
AU  - Marsh, T
AU  - Barnett, M.L
AU  - Aaron, R.M
AU  - Greenberg, E
AU  - Do Alexandra
AU  - Zhu, J.M
JO  - Health Affairs Scholar
PY  - 2026
VL  - 4
IS  - 3
DO  - 10.1093/haschl/qxag054
UR  - https://doi.org/10.1093/haschl/qxag054
AN  - 41878001
AB  - 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.
KW  - Medicare
KW  - primary care access
KW  - audit study
KW  - secret shopper
KW  - health system consolidation
KW  - wait times
KW  - industrial organization
KW  - health services research
ER  -