Physician availability depends on coverage type

Despite coverage expansion under the Affordable Care Act, the law does not guarantee physicians' availability or willingness to accept a patient's form of insurance, a new study from JAMA New Medicine finds.

The researchers had trained staff use a script to call primary care offices in 10 states and request a new patient appointment to determine whether physicians would accept patients who were privately insured, covered under Medicaid or uninsured, the study notes.

Those claiming to be a patient with private insurance had an 85 percent success rate for getting appointments, while those claiming to have Medicaid had a 58 percent success rate. For the uninsured, about 79 percent of people got appointments but only after saying they were willing to pay cash, reports Reuters.

"Establishing a relationship with a primary care provider is a pretty important step in realizing the benefits of healthcare," Karin Rhodes, M.D., the study's lead author from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, told Reuters. "We wanted to know if there was enough primary care capacity in the system to allow for the new enrollees coming in."

The lower Medicaid percentage suggests a real shortage of physicians who are able to care for those covered by the state-run insurance program for low-income families. Practices participating in Medicaid need to be located closer to where Medicaid beneficiaries live, the study finds.

However, the findings vary depending by state. Massachusetts, for example, reports 91.3 percent of its population has a regular source of care--the national mean is 71.1 percent.  So, this high percentage indicates Massachusetts provides access to primary care for the overwhelming majority of its residents, according to the study.

"This study suggests that even before this expansion that Medicaid beneficiaries' options may be limited," Andrew Bindman, M.D., who co-wrote an editorial accompanying the new study, told Reuters. "The addition of so many new enrollees into this program could put additional stress on a pool of physicians who were already stretched to meet the needs of Medicaid beneficiaries prior to this expansion."

For more:
- read the JAMA New Medicine study
- here's the Reuters article