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Medical Practices See No New Patient Increase, Despite ACA


More than 8 million patients have signed up for insurance due to the ACA, according to HHS, but where are all of them?

If your practice has not experienced an influx of new patients, it is not alone. A recent report found that there has been no sizable increase in new patient visits to medical practices since the Affordable Care Act (ACA) took effect.

The report, based on data on more than 14,000 practices in multiple specialties from healthcare technology company athenahealth, is part of a joint initiative between the Robert Wood Johnson Foundation (RWJF) and athenaResearch, a department of athenahealth.

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Want to hear more from Owen Dahl? Join us Sept. 19 & 20 in Philadelphia at Practice Rx, a new conference for physicians and office administrators. Dahl will share some of his top tips on how to improve your medical practice and your bottom line.

The data show that most specialty types did not experience higher new patient visit rates for the first five months of 2014 than they experienced during the same period in 2013. In fact, the report found that all specialties experienced lower new patient visit rates (with the exception of pediatric practices, which saw an increase of .6 percent overall).

According to HHS, however, more than 8 million patients signed up for insurance through the health insurance marketplace during the initial enrollment period, which ended March 31.

So why aren't practices encountering them?

"Just because they have insurance doesn't mean they would change their behavior," practice management consultant Owen Dahl told Physicians Practice via e-mail, adding that the report's findings don't surprise him.

"Either not going to the doctor or still using the emergency room for primary care is what I expected [of the newly insured]. The level of understanding about insurance in general, the bronze high deductible option, etc., are still foreign to the policyholder."

Dahl added that he anticipates little change in the rate of new patient visits throughout the rest of 2014. In fact, he said a measurable impact due to the ACA might not be felt for perhaps even five years.

Susanne Madden, president and CEO of practice management consultancy The Verden Group, cautioned, however, that the study findings may not provide the full picture of the ACA's influence on new patient rates.  

"... I would have liked to see a more robust analysis that specifically looked at those providers that were added to the HIX [health insurance exchange] plans, their scheduling patterns (e.g. did they add more new patient slots to their schedules?), and any changes to the diagnoses/health patterns at those practices," she told Physicians Practice via e-mail. "That is, in many instances, several payers only added 20 percent of their current network providers to their HIX plans. Looking at a huge sample size (like they have in this report), if only 10 percent of those docs were in the HIX plans then of course the numbers would be fractional."

In addition, the report failed to consider how many established patients in a practice switched from one plan to a plan through the health insurance marketplace, said Madden. "There were many underinsured that switched plans, so they would not be new patients but with better insurance may have been able to access more/better care through existing providers."

Has your practice experienced an increase in new patient demand in 2014? Has demand remained relatively flat? Share your experience in the comments section below.


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