More than three-quarters of physicians say private insurers have created at least some friction in how they treat patients, according to a new report from Medscape.
The “Private-Payer and Government Insurance Report 2026: Medicare, Medicaid, and More,” published Oct. 2, surveyed 751 physicians on how private insurance, Medicare and Medicaid are impacting their ability to provide care.
Here are 13 things to know from the report:
- More than 40% of physicians said that private-payer decisions influence treatment decisions “a great deal” or “quite a bit,” a slight increase from Medscape’s 2024 version of the report.
- About half of physicians reported a decline in private-payer rates, with 38% more reporting rates are about the same compared to the past five years.
- Physicians and their staff spend an average of about 13 hours a week on prior authorization, according to the American Medical Association, with four in 10 devoting staff exclusively to authorization.
- About four in 10 physicians reported that their offices’ interactions with private insurers are positive, compared with about 20% with negative experiences.
- More than half of physicians have had an increase in letters of medical necessity over the past five years.
- Only 5% of physicians said they have significant negotiating leverage when negotiating contracts with private payers. More than 40% of physicians said they have no negotiating leverage.
- More than half of physicians said they were supportive or very supportive of taking on more Medicare patients, compared with 33% for Medicaid. Support was higher among hospital-based physicians (61% for Medicare, 43% for Medicaid) and lower among those in solo practices (34% and 16%, respectively).
- Among physicians who see Medicare patients, 91% were participating providers. For practices that cap Medicare patients, reimbursement rates were a key reason for 87% of them and reimbursement delays factored in for 43%.
- Two-thirds of physicians expect Medicare to remain an important part of their practice, including 76% of hospital-based physicians and 54% of those in solo practices.
- More than three-quarters of physicians reported a moderate-to-large impact from Medicare pay cuts. The AMA says Medicare physician payments declined 33% between 2001 and 2026.
- Ninety percent of practices have seen a shift toward Medicare Advantage, per the Medical Group Management Association. Forty-four percent of physician respondents viewed the plans unfavorably, compared with 5% favorably, and 79% of MGMA respondents who saw the shift said it had a “negative impact” on their practice.
- Two-thirds of physicians named reimbursement rates as their biggest business concern with Medicaid.
- Nearly half of physicians who see Medicaid patients called prior authorization rules challenging or very challenging, including 54% of office-based physicians and 35% of hospital-based physicians.
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