MedicalResearch.com Interview with:
Molly Candon, PhD
Leonard Davis Institute of Health Economics, The Wharton School
Center for Mental Health Policy and Services Research, Perelman School of Medicine
University of Pennsylvania
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Primary care practices are less likely to schedule appointments with Medicaid patients compared to the privately insured, largely due to lower reimbursement rates for providers. Given the gap in access, concerns have been raised that Medicaid enrollees may struggle to translate their coverage into care. Despite the substantial increase in demand for care resulting from provisions in the Affordable Care Act (ACA), our 10-state audit study recently published in JAMA Internal Medicine finds that primary care appointment availability for new patients with Medicaid increased 5.4 percentage points between 2012 and 2016, while appointment availability for patients with private coverage did not change.
Over the same time period, both Medicaid patients and the privately insured experienced slight increases in wait times.
MedicalResearch.com: What should readers take away from your report?
Response: Our results suggest that the influx of millions of newly insured patients under the ACA has not overwhelmed primary care capacity. Factors that may explain providers’ ability to accommodate new patients include broad investments in primary care, such as the ACA’s allocation of funds to federally qualified health centers. Practices may also be extending wait times in order to expand their panel of patients.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: The Medicaid expansion is one of many provisions in the ACA.
As policymakers from across the political spectrum consider changes to the current health care system, it is crucial to understand the ACA’s impact on patient care.
MedicalResearch.com: Is there anything else you would like to add?
Response: Since this audit is restricted to in-network primary care offices, our estimates do not reflect changes in the size of Medicaid networks, the impact of Medicaid expansions on established patients, or the effects of the ACA in non-primary care settings. Further, concurrent changes to health care delivery may confound our ability to link Medicaid expansions to primary care access.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Polsky D, Candon M, Saloner B, Wissoker D, Hempstead K, Kenney GM, Rhodes K. Changes in Primary Care Access Between 2012 and 2016 for New Patients With Medicaid and Private Coverage. JAMA Intern Med. Published online February 27, 2017. doi:10.1001/jamainternmed.2016.9662
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