Appointment availability increased 5.4% and short wait times decreased 6.7% for Medicaid callers in 10 states studied since the ACA was implemented, according to research published in JAMA Internal Medicine.
For callers insured through private payers, appointment availability did not change significantly, and short wait times decreased 4.1%.
- Researchers hypothesized that changes to care delivery structures, such as increased reliance on team-based care, and a rise in alternative care settings, such as retail clinics, contributed to increased availability and shorter wait times.
Since the ACA went into effect, around 20 million more people have been added to health insurance roles. While many predicted increased coverage rates would lead to longer wait times and fewer doctors accepting new patients, that does not appear to be the case.
Debate over discrepancies in access to healthcare services afforded to Medicaid beneficiaries versus those with private insurance has been ongoing since well before the ACA became law. While it is true that doctors are more likely to accept new patients who have private insurance than those who have Medicaid, Medicaid beneficiaries are just as likely to have a regular source of primary care as patients with private insurance, according to 2014 Commonwealth Fund Biennial Health Insurance Survey.
Rather than exacerbate access discrepancies between patients with Medicaid and patients with private insurance, it appears these discrepancies could be growing smaller under the ACA. In 2013, 68.9% of office-based physicians were accepting new Medicaid patients and 84.7% were accepting new patients with private insurance, but the JAMA Internal Medicine study suggests the gap could be smaller now.
While discrepancies in access to primary care does not seem significantly different for Medicaid beneficiaries than for patients with private insurance, demand is growing and medical schools are not producing doctors quick enough to meet it. Some states, as well as the Veterans Affairs Department, are removing restrictions on nurse practitioners to accommodate rising demand.