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Health Care Reform:

Health Insurance & Affordable Care Act

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The rates of Medicaid acceptance are likely to prove problematic as more and more Americans sign up for Medicaid under the Affordable Care Act. “At the end of the day, it doesn’t matter how many physicians you have,” says Singleton. “If no one will take your insurance, you’re going to end in the same place, and that’s probably the ER.” And with more patients covered both by Medicaid and private insurance, he says, wait times are likely to get worse.

But Ken Hertz of the MGMA Health Care Consulting Group, which consults with physician practices, says wait times don’t always increase in proportion to patient volume. As plan deductibles and copays have gone up in recent years, patient volume in outpatient settings have actually declined, he says.

And long wait times can be attributed to many things other than patient volume, he adds, including operators not understanding the scheduling system. “Most practices are working diligently to see patients and see them in a timely manner, but there are a lot of moving parts,” he says.

“The successful practices will figure out new ways and approaches to shortening wait times. This isn’t going to be acceptable” in the long term, says Hertz.

This post was updated to correct information in the graph about Boston’s overall wait times. The current wait averages 45.4 days, while it was nearly 50 days in 2009 and 39 days in 2004.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.

Wed, Jan 29 2014

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