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Health Care Reform:

Health Insurance & Affordable Care Act

What Surge? Nation’s Primary Care System Holding Up Well So Far Under Obamacare


But Glied notes that Massachusetts’ residents historically had long waits for primary care visits so their experience is not a good indicator.

And unlike the Massachusetts law, the Affordable Care Act gave health providers more than three years to prepare. In that time, the federal government has spent billions expanding community health centers while private practices have added nurse practitioners and physician assistants and adopted electronic health records.

“Despite the widely publicized shortage of primary care physicians, primary care capacity does exist in each state,” said Karin Rhodes, director of the Center for Emergency Care Policy & Research at the University of Pennsylvania School of Medicine.

Rhodes was the lead author of a study published last month in JAMA Internal Medicine in which researchers posing as new patients called about 8,000 primary care practices in 10 states. The vast majority quickly secured appointments although those with Medicaid had a tougher time.

Physicians scheduled visits for 85 percent of callers posing as patients with private insurance, and for 58 percent of those posing as patients with Medicaid. Median wait times were just under one week.

Still, Rhodes said that people around the country will face varied experiences because the supply of doctors is uneven and the number of newly insured also varies dramatically.

Molina Healthcare, a large managed care firm that covers mostly Medicaid patients and runs health clinics in six states, said it is managing patient demand without hitches so far.

“We have seen some increased use, but it’s not been a problem,” said J. Mario Molina, chief executive of the Long Beach, Calif.-based company.

Molina, whose Medicaid enrollment grew 11 percent to 2.2 million this year, said he expects his clinics to get busier as state agencies plow through their backlogs and send cards to new enrollees.

Too Early To See Surge

Some physician groups still believe there will be delays when the late enrollees and patients still waiting for cards filter into the system.

“We have not felt the full impact of it yet,” said David Fleming, president of the American College of Physicians. “We are going to see a substantial increase in volume and it is going to be a problem because there are not enough primary care doctors.”

Mon, May 12 2014

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