AMA survey shows patient mix changed at practices due to Medicaid expansion

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New data from the AMA show physician practices have diminishing numbers of uninsured patients due to coverage in Medicaid expansion states.

The percentage of patients without health insurance coverage in physician practices shrank between 2012 and 2016, according to new research from the American Medical Association. Medicaid expansion represented the main driver of the change.

The AMA’s latest data come from its Physician Practice Benchmark Survey, conducted in 2012, 2014 and 2016, part of which tracks both patient mix and the type of coverage patients maintain.

Just under 76% of physicians served uninsured patients in 2016, down from a little more than 81% in 2012. Meanwhile, the share of Medicaid patients rose, with a noticeable boost in the 31 states and the District of Columbia that took advantage of Medicaid expansion under the ACA. The share of Medicaid patients in expansion states rose from 16.2% in 2012 to 17.6% in 2016, compared to a one-percentage-point share decrease in nonexpansion states, from 6.4% to 5.4%, in the same period.

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The report also noted that the percentage of physicians with uninsured patients fell by more than seven percentage points in states that took advantage of the Medicaid expansion, as compared to 2.2 percentage points in nonexpansion states.

Whether these trends will continue remains an open question, however, as recent reports from FierceHealthcare have tracked an uptick in the uninsured rate since 2016.

“Expanding Medicaid has provided much needed coverage to our low-income patients, improved access to care, and enhanced the health and well-being of the newly insured,” said AMA’s president, David O. Barbe, M.D., in an announcement accompanying the survey’s release. He went on to emphasize the policy impact of these findings, urging lawmakers to think of Medicaid expansion as more than a budgetary issue. “Lawmakers must also consider the real human effects of this decision, including the health and well-being of those who have gained coverage under expansion,” he added.

In terms of coverage mix, data from the survey showed a rise in the percentage of patients with private insurance plans between 2012 and 2016, compared to slight declines in the percentage of overall patients covered by Medicare and Medicaid.

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