More Physicians Are Leaving Medicare, JAMA Study Finds

The number of physicians participating in Medicare grew slightly from 585,642 in 2013 to 622,342 in 2023—a 6.3% increase. According to a new JAMA research letter, exits from the Medicare program accelerated sharply during the COVID-19 pandemic, reaching a decade high in 2023.¹

Researchers analyzed 100% of Medicare fee-for-service claims data, covering 11.6 billion services provided by more than 960,000 unique physicians over the decade. They found that although participation increased overall, the proportion of physicians leaving Medicare increased nearly 6 times, from 0.84% in 2013 to 4.73% in 2023.

“Physicians who resided in a nonmetropolitan county had a higher likelihood of exit compared with physicians in a metropolitan county,” wrote authors Jonathan Cantor, PhD; Rose Kerber, MPP; Cheryl L. Damberg, PhD, of RAND Corporation; and Christopher M. Whaley, PhD, of Brown University.

Who’s Leaving and Why It Matters

The study found certain demographic and specialty trends among those exiting. Women physicians were 25% more likely to leave the Medicare program than men. Older physicians were also far more likely to exit; those aged 60 years or older in 2013 were nearly 6 times more likely to leave than those younger than 30 years. Primary care physicians had a 12% higher likelihood of exiting compared with medical specialists.

Geography played a notable role. Physicians in rural (nonmetropolitan) counties and federally designated Health Professional Shortage Areas were more likely to stop billing Medicare, raising concerns about access for patients and already struggling to find care. The share of physicians in nonmetropolitan areas fell from 52,911 to 44,507 between 2013 and 2023.

The authors warned that these patterns could exacerbate existing access gaps for older and rural Americans. “The increased likelihood of Medicare program exits will likely reduce access to care for already underserved communities,” they wrote. “As these patient populations already experience more limited access to care, these trends may be associated with adverse health outcomes.”

Broader Context

The researchers noted that the analysis was limited to fee-for-service data and did not include Medicare Advantage, Medicaid, or commercial plans. Some physicians who appeared to exit Medicare may have shifted to other settings, such as Federally Qualified Health Centers or rural clinics.

The study, supported by the National Institute on Aging and the RAND Center of Excellence on Health System Performance, underscores how even modest national participation gains can mask deeper cracks in the physician workforce.

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REFERENCE

Cantor J, Kerber R, Damberg CL, Whaley CM. US physician Medicare program participation and exit, 2013-2023. JAMA. Published online October 20, 2025. doi:10.1001/jama.2025.15343