Apparently, there has been no measurable increase in the number of new sick patients as a result of the PPACA
In our previous report, we saw that, at least for the first quarter, a national sample of 12,700 physicians across the athenahealth network did not see an increase in new patients due to the ACA. While not all new patients are newly insured, an increase in this population would suggest that coverage expansion is having an impact on medical practices. Instead, the percentage of total provider visits with new patients actually dropped slightly in the first three months of 2014 compared to 2013. Several factors may help explain why the ACA’s coverage expansion has not led to an immediate and measurable impact:
- The number of newly insured patients in the first quarter of 2014 may have been too small to have a measurable impact.
- Not all newly insured patients required care.
- It may require weeks or months for patients to schedule appointments and be seen.
Our data suggests the influence of new patients on provider activity may take considerable time to unfold. Figure 1 shows the percentage of visits by new patients to Primary Care Providers (PCPs) at practice locations active before 2011. New patients account for 15% to 20% of office visits in the beginning of the year, growing as a proportion throughout the year. Note that a patient defined as new at any point during 2014 remains classified as new throughout the entire calendar year. In other words, these new patients are tracked as a cohort as the year progresses. We chose this definition to measure the level of effort physicians place in treating patients that are new to the practice across the year.
That’s a mixed bag. On the one hand it suggests that the new load on the healthcare system may be bearable but on the other it undercuts the argument in favor of the PPACA. The PPACA may have been the easiest thing for the Democratic Congress of 2009 to enact but it may not have been the reform that was needed. As to whether it will be sustainable, it’s just too early to tell.
The linked post is interesting in general and worth reading in full.