Published Nov. 11, 2020
The number of Medicare-participating health care providers can vary widely from one area to the next. This leaves an uneven health care landscape that can result in better health outcomes for seniors in certain areas of the country who have access to a higher number of doctors and specialists.
To determine where these health care disparities are the most pronounced, we analyzed Medicare provider market saturation for a variety of health care specialties and found out which areas of the country have the highest number of Medicare providers per 100,000 Medicare beneficiaries in that area.
We used data from the Centers for Medicare & Medicaid Services (CMS) that uses core-based statistical areas (CBSAs) to define boundary lines between one market area and another. A CSBA consists of one or more counties (or equivalents) that are anchored by an urban center of at least 10,000 people, plus adjacent counties that are considered socioeconomically tied to the urban center.
The cities and towns found in the charts below refer to the anchor town of their respective CBSA, which can span hundreds of square miles.
Top Cities for Each Type of Medicare Provider
The chart below shows the areas of the country with the highest density of Medicare providers across a range of specialties and services, as measured per 100,000 beneficiaries.
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One notable finding is the high concentration of Medicare providers in Texas. The Lone Star State placed seven CBSAs among the top 17 in the nation for various Medicare services.
- The areas surrounding Levelland in the northwest of Texas have a high concentration of skilled nursing facilities and dialysis centers.
- Raymondville in the southern tip of the state has the highest concentration of ophthalmology and home health care specialists who accept Medicare beneficiaries.
Minnesota was the only other state to place more than one CBSA as the top in the nation for a given specialty area. The highest concentration of Medicare chiropractors in the nation is in the area around Marshall, MN, and the nation’s highest concentration of Medicare psychotherapists (mental health counselors and therapists) is around Mankato and North Mankato, MN.
Top 5 Cities for Medicare Cardiac Rehab
Cardiac rehab is designed to boost your cardiovascular health following a heart attack, heart failure, heart surgery or angioplasty.
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As you can see from the chart, Illinois is the place to be for Medicare beneficiaries who need cardiac rehabilitation.
Three of the top five areas in the country for cardiac rehab are in Illinois, including each of the top two in Macomb and Lincoln. The three Illinois towns (to include Taylorville) are located in relatively close proximity to each other in central Illinois’ Springfield area.
Top 5 Cities for Medicare Skilled Nursing Facilities
Skilled nursing facilities provide inpatient rehabilitation for a period of time – often following a stroke, fall or other episode – until the patient is ready to return home.
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The area with the most skilled nursing facilities per capita is in the northwest of Texas, around the town of Levelland. About 30 miles west of Lubbock, this town of around 14,000 serves as the county seat of Hockley County and of the local CBSA.
Also cracking the top five from Texas was the Raymondville area. As mentioned above, Raymondville is home to the nation’s highest concentration of ophthalmology and home health care specialists who accept Medicare.
Top 5 Cities for Medicare Telemedicine
Telemedicine involves conducting doctor’s appointments virtually by use of video conferencing software and apps like Skype, Zoom or FaceTime.
Telehealth services allow patients to communicate with their health care provider from the safety and convenience of their own home and is a valuable tool for those who have difficulty getting to a physical doctor’s office.
The value of telemedicine has been amplified in 2020, with many people — particularly seniors — becoming leery of visiting a doctor’s office in person given the coronavirus exposure risk. Medicare even expanded its telehealth coverage in response to the COVID-19 pandemic.
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The area with the highest density of telemedicine providers (by a large margin) is found around Mitchell, SD, in the southeastern part of the state. This CBSA has 36% more Medicare providers of telehealth than any other area in the U.S.
Texas was well-represented among Medicare telemedicine providers, with the areas around Sulphur Springs in the northeast and Zapata in the south making the top five in the nation.
Top 5 Cities for Medicare Emergency Ambulance Services
The readiness and response of an ambulance can make the difference between life and death in an emergency.
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The area of Kentucky’s capital city of Frankfort has the largest number of Medicare emergency ambulance services per capita in the U.S., at 377 providers per 100,000 people. That was significantly higher than the 221 per 100,000 people found in the area around Kingsville, TX, and more than double that of Huntingdon, PA, which was the area with the fifth-highest density in the nation.
Two areas in central Pennsylvania, encompassing Selinsgrove and Huntingdon, made the top five. Texas was once again represented with a top 5 city for a Medicare service area.
Top 5 Cities for Medicare Occupational and Physical Therapy
Occupational therapy helps patients restore motor skills they use for activities such as dressing, writing or using scissors. Physical therapy helps patients regain body movements and function on a larger scale.
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Across the U.S., there are two areas that stand out for their high number of physical and occupational therapists per capita.
- The first is located on the eastern edge of Wyoming, in an area that encompasses the town of Jackson and spills over into neighboring small towns in Idaho.
- The second is an area in the southern part of Montana, around Bozeman, located halfway between Billings and Butte.
The area around Missoula, near Montana’s western border, ranked third in the nation.
Total Number of Medicare Providers and Spending Per Service
There are a total of 4,578,112 health care providers across the country who accept Medicare patients and are included in our study.
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Of the providers we included in our review, more than two million are in the category of preventive services providers, which include primary care and general doctors. This is nearly four times as many as the next-highest specialty (physical and occupational therapists) and makes up 44% of the total number of providers we included.
There are more ambulance providers who bill for non-emergency ambulance services than there are emergency ambulance providers. We also found there are 60% more psychotherapists who accept Medicare than there are chiropractors who take Medicare patients.
In addition, we analyzed the amount of money that Medicare spends on each particular service, as highlighted by the chart below.
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Independent diagnostic testing facilities that billed either Medicare Part A or Part B took in more than $70 million from Medicare from 2015 to 2018, the most of any health care specialty, facility or service.
Chiropractors accounted for the fifth-highest number of Medicare providers but ranked just 17th in Medicare billing compared to other Medicare specialists and facilities.
Hospice providers and home health care services combined to account for more than $65 million in Medicare billing, despite each being lower on the list of total number of Medicare providers in the nation.
Methodology
This report relies on data taken from the Market Saturation and Utilization Data Tool provided by the Centers for Medicare & Medicaid Services (CMS) for January 1, 2015 through December 31, 2018.
Medicare billing code definitions and additional technical information can be found in the Market Saturation and Utilization Data Tool Technical Guide.
Fair Use Statement
Of course we would love for you to share our work with others. We just ask that if you do, please grant us the proper citation with a link to this study so that we may be given credit for our efforts.
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