Report: Doctors Not Seeing a Surge in New Patients Under ACA

Physician practices have not been overwhelmed with patients since the Affordable Care Act’s individual mandate took effect in 2012, according to a report by athenahealth, a cloud-based health IT vendor, and the Robert Wood Johnson Foundation, Modern Healthcare reports.

The report is based on data from athenahealth members, which tend to be larger provider practices.

According to Modern Healthcare, critics of the ACA had warned that the individual mandate would result in a flood of new patients into the U.S. health care system. However, the report found that the share of new patient visits at primary care providers increased by only three percentage points from 2013 to 2014. In addition, there was no evidence that cases were more serious than they had been in the past.

However, the report did find that providers are conducting more comprehensive new patient assessments. Such assessments increased by 4.5% from 2013 to 2014.

Katherine Hempstead, RWJF director of health insurance coverage, said that overall the report “shows that the delivery system does not appear to be overwhelmed by the overextension in coverage” and that the increase “in new patients is not of a magnitude that would cripple the delivery system.”

Further, the report looked at the uninsured rates among individuals visiting physician practices. It found that the share of visits from uninsured patients decreased from 4.6% to 2.8% during 2014. According to the report, 36.5% of 100,000 patients who kept their PCPs and who were uninsured for at least some part of 2012 to 2014 gained coverage after the individual mandate took effect, while 27.8% became covered the previous year.

According to the report, the share of Medicaid beneficiaries that providers treated in non-expansion states between 2013 and 2014 declined by 10.8%. The report noted, “We speculate that providers in non-expansion states may have prioritized seeing new patients with commercial coverage obtained through the exchanges over patients who gained coverage through Medicaid.”

Meanwhile, providers in expansion states experienced a rapid increase in the share of Medicaid patients they saw. Medicaid patients accounted for 12.2% of all PCP visits in December 2013 and 15% of such appointments in March 2014 in those states. That share peaked at 16.7% in September 2014 and dropped to 15.5% in December 2014, according to the report (Rubenfire, Modern Healthcare, 3/25).

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