Expansion of health care coverage mandated by health reform will push demand for primary care providers sharply upward, and thousands of new physicians are necessary to accommodate the increase, a new study finds.
Health care consumers should expect that in the period immediately following the coverage expansion, they may experience some difficulties getting timely appointments. It really depends where they are located geographically and how quickly those who obtain coverage pursue care, said study co-author Jean Marie Abraham, Ph.D.
Using 2006 and 2007 data from the Medical Expenditure Panel Survey, a survey that included 33,768 adults and 17,572 children, and other sources, Abraham and colleagues predicted state-by-state annual increases in primary care visits as the result of the Patient Protection and Affordable Care Act, passed into law in 2010. The legislation extends health care coverage to an estimated 32 million uninsured people in the United States.
Overall, the authors expect the number of annual primary care visits to rise by about 15 million to 24 million visits by 2019. These increases only take into account the health care coverage expansion, not other factors that could increase annual primary care visits, such as the aging population, the authors say.
The study appears in the latest issue of the journal The Milbank Quarterly.
Places that have a high percentage of uninsured will have the biggest increase in demand and will experience the biggest shock to the delivery system, said Abraham, a health economist and assistant professor at the University of Minnesota School of Public Health. Of the states, California, Texas and New York will experience the largest increases in demand and use of providers.
For consumers, the effect of expanded coverage differs depending on your perspective. If you have wanted to get insurance and couldnt get it, its good news. If you have health insurance and an established relationship with a physician, you wont see any change. If you are looking for a new primary care physician, you may find longer waits, said Robert Field, Ph.D., a professor at the Drexel University School of Public Health in Philadelphia. He has no affiliation with the study.
To cover the increases, the authors predict that between 4,307 and 6,943 more primary care physicians will be necessary. However, Field said, they dont take into account the number of positions that will be filled by non-physician clinicians, such as nurse practitioners and physicians assistants. Well undoubtedly be seeing more of that.
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Hofer AN, et al. Expansion of coverage under the Patient Protection and Affordable Care Act and primary care utilization. Milbank Q 89(1), 2011. onlinelibrary.wiley.com/doi/10.1111/j.1468-0009.2011.00620.x/full