Nav: Home

Gauging ACA's effect on primary care access

February 27, 2017

A new research letter published online by JAMA Internal Medicine assessed the Affordable Care Act's effect on primary care access because millions of uninsured adults have gotten health insurance since major coverage provisions were implemented.

The study by Daniel Polsky, Ph.D., of the University of Pennsylvania, Philadelphia, and coauthors used simulated patients to request new patient appointments from primary care practices in 10 states: Arkansas, Georgia, Illinois, Iowa, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania and Texas. A baseline study was conducted from 2012-2013 and updated in 2016 with an updated sample group of practices.

Simulated callers were grouped by insurance type (Medicaid or private insurance) and clinical scenario (hypertension or a check-up). The authors analyzed changes in appointment availability and the probability of short wait times (one week or less) and long wait times (more than 30 days).

The authors report that across the 10 states:
  • Medicaid callers saw appointment availability increase 5.4 percentage points and short waits decrease 6.7 percentage points between 2012 and 2016.
  • Private insurance callers saw no significant change in appointment availability but short waits decreased by 4.1 percentage points and long waits increased 3.3 percentage points.


There was no significant change in appointment availability for either insurance type in Georgia, Massachusetts, Montana, New Jersey or Texas. Medicaid callers found increased appointment availability in Illinois, Iowa and Pennsylvania, while private insurance callers found increased availability in Pennsylvania but decreased availability in Oregon and Arkansas.

The study has limitations such as including only new simulated patients calling in-network offices and that the results may not be generalizable because it includes only 10 states.

"The appointment availability results should ease concerns that the Affordable Care Act would exacerbate the primary care shortage. ... Primary care practices may be adapting to an influx of new patients with shorter visits and more rigorous management of no-shows," the article concludes.
-end-
(JAMA Intern Med. Published online February 27, 2017. doi:10.1001/jamainternmed.2016.9662; available pre-embargo at the For The Media website.)

Editor's Note: The article contains funding/support disclosures. Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

The JAMA Network Journals

Related Health Insurance Articles:

Health insurance expansion linked to fewer sudden cardiac arrests
The incidence of sudden cardiac arrest, a sudden and usually deadly loss of heart function, declined significantly among previously uninsured adults who acquired health insurance through the Affordable Care Act, also known as 'Obamacare,' according to a study published today in the Journal of the American Heart Association.
Analysis indicates that insurance expansion improves access to care, health, and survival
There is strong evidence that expanding health insurance increases access to care, improves health in a variety of ways, and reduces mortality, according to Harvard T.H.
Generous health insurance plans encourage overtreatment, but may not improve health
Offering comprehensive health insurance plans with low deductibles and co-pay in exchange for higher annual premiums seems like a good value for the risk averse, and a profitable product for insurance companies.
Study shows health insurance plans too complicated to understand
A new survey by experts at the Health Disparities Institute of UConn Health shows that many patients across Connecticut are struggling to understand their complex, jargon-filled private health insurance plans and even to use their plan benefits correctly.
With health insurance at risk, community health centers face cut-backs
Repeal of key provisions of the Affordable Care Act, combined with a failure to renew critical funding streams, would result in catastrophic funding losses for community health centers-forcing these safety net providers to cut back on services, lay off staff or shut down clinical sites, according to a report published today.
Evaluating the benefits of health insurance on cancer care
A new Dartmouth study shows that patients have lower rates of cancer-specific survival based on where they live and their social determinants of health.
American College of Physicians praises blocked health insurance merger
The American College of Physicians (ACP) praises the ruling by a federal judge yesterday that blocked a proposed merger between health insurers Aetna and Humana.
More with mental illness and substance use disorders have health insurance
Significantly more people with mental illness and substance use disorders had insurance coverage in 2014 due to the expansion of health insurance under the Affordable Care Act, but many barriers to treatment remain, new Johns Hopkins Bloomberg School of Public Health research suggests.
'Cadillac tax' may precipitate changes to employer-provided health care insurance
Even if the Affordable Care Act is ultimately repealed, the law's so-called 'Cadillac tax' on high-cost health care plans has already affected employers' health insurance offerings, says Richard L.
Study links health literacy to higher levels of health insurance coverage
The federal Affordable Care Act is intended to make it easier for individuals to buy health insurance, but are the uninsured equipped to navigate the choices faced in the insurance marketplace?

Related Health Insurance Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#530 Why Aren't We Dead Yet?
We only notice our immune systems when they aren't working properly, or when they're under attack. How does our immune system understand what bits of us are us, and what bits are invading germs and viruses? How different are human immune systems from the immune systems of other creatures? And is the immune system so often the target of sketchy medical advice? Those questions and more, this week in our conversation with author Idan Ben-Barak about his book "Why Aren't We Dead Yet?: The Survivor’s Guide to the Immune System".