Primary Care Access Remains Unaffected By Medicaid Expansion

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"Short waits" — a wait of 1 week or less — for primary care appointments decreased among those with either Medicaid or private insurance.
"Short waits" — a wait of 1 week or less — for primary care appointments decreased among those with either Medicaid or private insurance.

HealthDay News — Doctors' offices capably shouldered the burden of millions of new Medicaid patients gaining access to health insurance through the Affordable Care Act, according to a research letter published online in JAMA Internal Medicine.

Daniel Polsky, PhD, executive director of the University of Pennsylvania School of Medicine's Institute of Health Economics in Philadelphia, and colleagues staffed a phone bank with people pretending to be new patients seeking appointments. The phone staff called primary care practices in 10 states — Arkansas, Georgia, Illinois, Iowa, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania, and Texas. The callers randomly represented themselves as patients having either Medicaid or private insurance coverage. The calls came in 2 waves, in 2012 and again in 2016.

The researchers found that 63.2% of doctors were willing to take on a new Medicaid patient in 2016 across all the states, compared with 57.9% in 2012. At the same time, patients with private insurance experienced no significant change in appointment availability. Short waits — 1 week or less — decreased by 6.7% for Medicaid patients between 2012 and 2016, and by 4.1% for patients with private insurance. Long waits — more than 30 days — increased by 3.3% for patients with private insurance.

"The evidence we've generated does not support making major adjustments to the current Medicaid program," Polsky told HealthDay. "We can increase the number of people [who] can access care through Medicaid without seeing any decline in the number of doctors willing to see them."

Reference

Polsky D, Candon M, Saloner B, et al. Changes in primary care access between 2012 and 2016 for new patients with Medicaid and private coverage [published online February 27, 2017]. JAMA Intern Med. doi: 10.1001/jamainternmed.2016.9662

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