The Robert Wood Johnson Foundation and athenahealth have released the first in an ongoing series of comprehensive reports based on the organizations' ACAView, a joint initiative that measures the impact of the Affordable Care Act on providers, patients, and physicians.

The first report analyzes the impact of the ACA through May of 2014. ACAView monitors the impact of coverage expansion, mining insights from a subset of athenahealth’s cloud-based network of more than 52,000 healthcare providers and 56 million patients.

The report focuses on the provider perspective, showcasing how the ACA affects the practice patterns and economics of physicians and other care team members around the country.

Key findings from the report include:

* Influx in New Patient Volume Not Detected: In the first five months of 2014, a national sample of 14,300 healthcare providers across the athenahealth network did not see an increase in new patient volume. Instead, the percentage of total visits with new patients actually dropped slightly compared to the same period in 2013. These findings suggest that an increase in newly insured patients, resulting from the ACA, has yet to have an impact on new patient volume at medical practices.

* Healthcare Reform Widening the Medicaid Gap: In states that are expanding Medicaid coverage under the ACA, the data shows an overall increase in adult (18-64) Medicaid beneficiary patient visits. In expansion states, on average, the percentage of Medicaid-covered patients who are being seen by primary care physicians is rising, with Medicaid patients accounting for 12.3 percent of care in December of 2013 compared with an increased rate of 15.6 percent in May 2014. Surgeons and other specialists also show increases. Conversely, states that are not expanding Medicaid coverage have seen Medicaid visits remaining flat. These findings indicate that the implementation of the ACA is widening the gap of the total share of Medicaid patients that doctors in expansion vs. non-expansion states are caring for.

* No Increase in Chronic Disease Diagnoses Among New Patients: Findings from the first five months of 2014 indicate that established patients have a higher rate of chronic diseases compared with new patients seeking care. When comparing diagnosis rates of chronic conditions from the first five months of 2013 to the first five months of 2014, across both new and established patients, no increase in diagnosis rates of chronic conditions is detected for either population.

The full report is available here.

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