Data from 15,000 physicians' records indicates that doctors' offices are not being overwhelmed by new patients receiving insurance coverage under the Affordable Care Act.
A new report, prepared by cloud-based EHR and services vendor athenahealth, found primary care physicians had 22.6 percent of their visits from new patients in 2013 and 22.9 percent in 2014. Similarly, small increases were evident for pediatricians and surgeons, while the proportion of new-patient visits was flat for OB/GYNS and declined slightly for other medical specialists.
However, the reporting practices did prepare evaluation and management codes at a higher rate in 2014 compared to 2013. In 2014, new patient E&M codes were used in 7.0 percent of all visits, compared to 6.7 percent in 2013, a relative increase of 4.5 percent. A potential implication is that the ACA may have increased the rate at which physicians are establishing new relationships with patients.
The report also found the new patients do not appear to be significantly sicker nor their cases more complex than new patients in 2013. Work Relative Value Units per patient visit remained constant; diagnoses per visit increased from 2.0 to 2.1; and the number of high complexity E&M codes actually declined from 8.0 percent to 7.5 percent for all visits.
"This very unique data allows us to gain an understanding of how health reform is affecting physician practices so far," said Kathy Hempstead, who directs coverage issues at the Robert Wood Johnson Foundation, which funded the report. "Contrary to what many anticipated, physician waiting rooms aren't being flooded by sicker-than-average newly insured patients. 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."
The report also found uninsured patient visits have fallen dramatically in Medicaid expansion states, where eligibility requirements have been relaxed. Uninsured visits have even fallen in non-expansion states, although not as sharply as in expansion states, where increased publicity may have drawn those qualified under the existing laws to apply.
The full report may be downloaded here.
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