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Access to Primary Care Appointments Following 2014 Insurance Expansions.
Rhodes, Karin V; Basseyn, Simon; Friedman, Ari B; Kenney, Genevieve M; Wissoker, Douglas; Polsky, Daniel.
Afiliação
  • Rhodes KV; Northwell Health, Great Neck, New York krhodes@northwell.edu.
  • Basseyn S; Perelman School of Medicine, Philadelphia, Pennsylvania.
  • Friedman AB; Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania.
  • Kenney GM; Perelman School of Medicine, Philadelphia, Pennsylvania.
  • Wissoker D; Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania.
  • Polsky D; The Wharton School, Philadelphia, Pennsylvania.
Ann Fam Med ; 15(2): 107-112, 2017 03.
Article em En | MEDLINE | ID: mdl-28289108
PURPOSE: The Patient Protection and Affordable Care Act (ACA) expanded coverage to roughly 12 million individuals by mid-2014 and 20 million by 2016, raising concern about the capacity of the primary care system to absorb these individuals. We set out to determine how justified the concern was. METHODS: We used an audit design in which simulated patients called primary care practices seeking new-patient appointments in 10 diverse states (Arkansas, Georgia, Iowa, Illinois, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania, and Texas) from November 2012 through March 2013 and from May 2014 through July 2014, before and after the major ACA insurance expansions. Callers were randomly assigned to scripts specifying either private or Medicaid insurance and called only offices identified as "in network" for each plan. RESULTS: We completed 5,385 private insurance and 4,352 Medicaid calls in 2012-2013 and 2,424 private insurance and 2,474 Medicaid calls in 2014. Overall appointment rates for private insurance remained stable from 2012 (84.7%) to 2014 (85.8%) with Massachusetts and Pennsylvania experiencing significant increases. Overall, Medicaid appointment rates increased 9.7 percentage points (57.9% to 67.6%) with substantial variation by state. Across all callers, median wait times for those obtaining an appointment were 7 days in 2012 and 5 days in 2014, but the difference was not statistically significant. CONCLUSIONS: Contrary to widespread concern, we find no evidence that the millions of individuals newly insured through the ACA decreased new-patient appointment availability across 10 states as shown by stable wait times and appointment rates for private insurance as of mid-2014.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Agendamento de Consultas / Patient Protection and Affordable Care Act / Acessibilidade aos Serviços de Saúde / Seguro Saúde Tipo de estudo: Clinical_trials Limite: Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Agendamento de Consultas / Patient Protection and Affordable Care Act / Acessibilidade aos Serviços de Saúde / Seguro Saúde Tipo de estudo: Clinical_trials Limite: Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2017 Tipo de documento: Article