Obamacare didn't lead to 'wave' of patients as feared
Remember nightmarish predictions that newly insured Obamacare patients would flood doctor's offices seeking long-delayed treatment? Well, that never happened.
Physicians nationally aren't even close to being swamped by new and sicker-than-average patients, and waiting times for visits actually dropped by one minute on average, according to new reports.
The findings contradict fears expressed before the launch of Affordable Care Act insurance plans that expanding health coverage to more people would strain doctors' offices when those people went to use their new insurance.
Last year saw about 10 million previously uninsured people get new health coverage either through Obamacare exchanges that sell private insurance plans, or through Medicaid, the government-run program for the poor that nearly 30 states have expanded to cover more people.
The first study was prepared by Athenahealth with funding from the Robert Wood Johnson Foundation.
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It found that "the proportion of new-patient visits to primary-care physicians increased very slightly, from 22.6 percent in 2013 to 22.9 percent in 2014."
And, "new patients visiting physician offices in 2014 were not sicker or more complex in 2014," the report said.
But the report did find significant drops in the number of visits by patients without health insurance—and more so in states that expanded their Medicaid programs.
In so-called expansion states, the rate of physician visits by uninsured people fell nearly 40 percent, from 4.6 percent of patients down to 2.8 percent in 2014. In nonexpansion states, the proportion of physician visits by the uninsured fell from 7 percent to 6.2 percent, an 11 percent decrease.
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"Contrary to what many anticipated, physician waiting rooms aren't being flooded by sicker-than-average, newly insured patients," said Kathy Hempstead, who directs coverage issues at the Robert Wood Johnson Foundation. "So far, the increase in demand is moderate, and new patients do not appear to differ much from established patients in terms of their chronic conditions and use of health services."
Hempstead's remarks were borne out by another report, issued Thursday by Vitals, a company that helps consumers find doctors. It said that even with some newly insured patients from Obamacare, patients overall weren't seeing longer wait times on average nationally as of this year.
In fact, Vitals' annual Physician Wait Time Report found that the average wait times for visits to the doctor dropped to 19 minutes and 16 seconds in 2015, "a full one-minute shorter than the 2014 wait time average."
"In fact, wait times for primary care doctors, the doctors Americans see the most, were generally down over one minute [one minute, 11 seconds] in a year-over-year comparison," according to the report.
The Vitals report said several factors could be contributing to the decline in wait times, including urgent care centers and retail clinics being used more, which would relieve traffic from visits to primary care doctors. Vitals said medical providers such as nurse practitioners and physician assistants "may also be easing doctor caseloads."
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The two reports come a month after an analysis by the Commonwealth Fund estimated that, even if all states expanded Medicaid, demand for health-care services would increase only slightly. The Commonwealth Fund analysis estimated that the number of annual primary care visits would rise 3.8 percent nationally.
One caveat to the studies comes from Susan DeVore, the president and CEO of Premier, a health-care improvement company that has an alliance with 3,400 hospitals. DeVore said data suggests Obamacare may be having a bigger effect in hospitals than in doctors' offices.
Premier has access to 1 in 3 patient discharges in the U.S., and it appears that "quarterly discharges in both the hospital in-patient and out-patient settings [are] at their highest levels in two years."