News Feature | April 17, 2015

ACA Not To Blame For Overwhelmed Docs

Katie Wike

By Katie Wike, contributing writer

Doctor Purge UnitedHealth

Data from American doctors shows the Affordable Care Act is not overwhelming doctors with new patients.

The statistics are in and, according to a data from atenahealth, the Affordable Care Act is not causing overwhelming providers with an influx of new patients. By analyzing EHRs of 15,000 physicians, researchers funded by the Robert Wood Johnson Foundation were able to determine that - despite the belief that the ACA would send masses of new patients to already short-staffed doctors - most physicians saw only slightly more new patients compared to previous years.

“In the run-up to the coverage expansion aspects of the Affordable Care Act, there was a concern a lot of these patients might have unmet medical needs and their demand for services might overwhelm the capacity of primary care doctors. We just haven't seen that,” said Josh Gray, VP of athenahealth's research division, according to USA Today. “That rush has just not materialized across our network.”

Health Data Management reports the study also revealed a number of trends, including:

  • primary care physicians had 22.6 percent of their visits from new patients in 2013 and 22.9 percent in 2014
  • similar results were found for pediatricians and surgeons
  • the rate of new patients remained the same for OB/GYNs
  • rates actually declined for other medical specialties

Researchers also point out new patients do not appear to be sicker or require more complex care:

  • Work Relative Value Units per patient visit remained constant
  • diagnoses per visit increased from 2.0 to 2.1
  • the number of “high complexity” E&M codes actually declined from 8.0 percent to 7.5 percent for all visits

“This very unique data allows us to gain an understanding of how health reform is affecting physician practices so far,” said Kathy Hempstead, who directs coverage issues at the Robert Wood Johnson Foundation. “Contrary to what many anticipated, physician waiting rooms aren't being flooded by sicker-than-average newly insured patients. So far, the increase in demand is moderate, and new patients do not appear to differ much from established patients in terms of their chronic conditions and use of health services.

“It really suggests that, even though there's been a big increase in coverage, it's a relatively small part of the market and the delivery system is able to handle the demand.”