ACA Medicaid Expansion Will Require More Primary Care Providers, Especially In Low Income Areas

MedicalResearch.com Interview with:
Eric T. Roberts and Darrell Gaskin
Johns Hopkins University Bloomberg School of Public Health
Baltimore, MD

Medical Research: What is the background for this study? What are the main findings?

Response: This study looked at the implications of the Affordable Care Act’s expansion of Medicaid on the need for additional physicians working in primary care. Since 2014, 11 million low-income adults have signed up for Medicaid, and this figure will likely increase as more states participate in the expansion. Many new Medicaid enrollees lacked comprehensive health insurance before, and will be in need of primary and preventive care when their Medicaid coverage begins. In light of these questions, in this study, we projected the number of primary care providers that are needed to provide care for newly-enrolled adults.

We forecast that, if all states expand Medicaid, newly-enrolled adults will make 6.1 million additional provider visits per year. This translates into a need for 2,100 additional full time-equivalent primary care providers. We conclude that this need for additional providers is manageable, particularly if Congress fully funds key primary care workforce training programs, such as the National Health Service Corps.

Medical Research: What should clinicians and patients take away from your report?

Response: Policies that focus on the recruitment of physicians to low-income areas that are medically under-served can help to meet the health care needs of newly-insured adults. Although training more health care workers – to meet the needs of an aging population and workforce turnover – is important, clinicians and policy makers should also pay close attention to the effects of workforce policies on where providers work.

Physicians entering the workforce after completing their training may take a number of factors into consideration when deciding where to practice. Young physicians should consider the valuable opportunities for hands-on training and financial assistance paying off student debt that are available through programs like the National Health Service Corps (NHSC). Physicians should also work closely with policy makers to identify strategies that can improve recruitment to the NHSC and promote the long-term retention of Corps members in the communities they serve.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Policy makers need evidence about the effectiveness of the Affordable Care Act’s various workforce development programs in order to prioritize funding for future initiatives. The ACA expanded support for the NHSC, in addition to Title VII funding for medical education and clinic-based graduate medical education, in an effort to expand the pipeline of professionals entering the primary care workforce in high-need communities. Evaluating the effectiveness of these different programs, on both the short-term recruitment and the long-term retention of professionals in primary care, will help policy makers invest in programs that deliver care to populations that need it the most.

Citation:

Projecting Primary Care Use in the Medicaid Expansion Population Evidence for Providers and Policy Makers
Eric T. Roberts and Darrell J. Gaskin
Med Care Res Rev 1077558715588435, first published on June 10, 2015 doi:10.1177/1077558715588435

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