Study finds Portland clinics rarely accept new Medicare patients, with primary care waits stretching for months

Portland’s primary care bottleneck for Medicare patients

A new multi-city audit of primary care appointment availability found that Portland has substantially lower access for new Medicare patients than three other large U.S. metropolitan areas surveyed. The research used a simulated-patient, “secret shopper” approach to measure whether clinics would take a new Medicare patient and how long the earliest offered appointment would take.

Researchers contacted 444 primary care clinics across four metro areas—Portland, New York City, Los Angeles and Chicago—posing as Medicare beneficiaries seeking an initial primary care visit. The study was published online March 9, 2026, as an accepted manuscript in a peer-reviewed health policy journal.

Key findings: acceptance rates and wait times

• Across all four cities, 77.5% of clinics reported accepting new Medicare patients.

• Portland had the lowest acceptance rate: 35.0% of contacted clinics reported taking new Medicare patients.

• Los Angeles had the highest acceptance rate: 96.9% of clinics reported accepting new Medicare patients.

• Among clinics that did accept new Medicare patients, the median wait time to the earliest physician appointment ranged from 8 days in New York City to 61 days in Portland.

What the study suggests about why Portland differs

The analysis links access constraints to organizational structure and market context, not simply the overall number of clinicians in a region. In adjusted statistical models, clinics that were part of larger organizations were less likely to accept new Medicare patients. Each additional practice site within an organization was associated with a 1.5 percentage-point lower probability of accepting new Medicare patients.

The study also found longer waits at hospital- or health system–affiliated practices. Those affiliations were associated with waits about 15 days longer than independent practices, with the longest delays concentrated in Portland.

Primary care functions as the entry point to ongoing health management, preventive services and coordinated treatment, particularly for older adults with multiple conditions.

Why it matters for Portland-area residents

Primary care access is a practical gateway to timely diagnosis, chronic disease management and referrals. When clinics are not accepting new patients—or when waits extend for weeks to months—patients may delay needed care or turn to urgent care or emergency departments for issues typically handled in primary care settings.

The findings are based on phone-based scheduling interactions from November 2024 through April 2025. The study focused on new Medicare patients and did not measure access for other insurance types, nor did it evaluate clinical outcomes. Still, the results provide a standardized comparison across cities and point to the importance of monitoring appointment access alongside workforce and health system consolidation trends.