A new report shows that a year after the Affordable Care Act’s coverage expansion provisions took effect, physicians have not experienced a sharp increase in visits by new or sick patients.
The report was prepared by Athenahealth, Inc., which provides office management software systems to medical practices, and was funded by the Robert Wood Johnson Foundation. It draws on data from 15,700 physician offices.
Key findings include:
- New patient volume did not increase significantly during 2014. In fact, new patient visits to primary care providers increased very slightly and were no more complex than those in 2013.
- The ACA has decreased the overall proportion of uninsured patients receiving care in physician offices, especially in Medicaid expansion states.
- The number diagnoses per patient visit also did not increase sharply compared to the previous year’s data.
“Contrary to what many anticipated, physician waiting rooms aren’t being flooded by sicker-than-average newly patients,” said Kathy Hempstead, who directs coverage issues at the Robert Wood Johnson Foundation. “So far, the increase in demand is moderate, and new patients do not appear to differ much from established patients in terms their chronic conditions and use of health services.”
Other findings include:
- New patients are less likely to be uninsured than they were as recently as a year ago. Medicaid expansion has bolstered coverage for the previously uninsured, as well as for the working poor. uninsured patient visits have also fallen dramatically in Medicaid expansion states. Uninsured visits have also fallen in non-expansion states, although not as sharply, possibly because increased publicity may have drawn those qualified for Medicaid under the existing laws to apply.
- Providers in Medicaid expansion states are seeing more Medicaid patients, which reflects the growing number of beneficiaries. Those in non-expansion states are receiving more visits from commercially- insured patients, which may reflect the success of health care exchanges there.
- A small but growing number of commercially insured patients switched to Medicaid in expansion states, possibly because Medicaid’s lower out-of-pocket costs are attractive to low-income workers compared to the expense of commercial insurance.
The full report is available online.
