Access to primary care appointments varies by insurance status

Individuals posing as patients covered by private insurance were more likely to secure a new-patient appointment with a primary care physician compared to individuals posing as patients covered by Medicaid or uninsured.

The Patient Protection and Affordable Care Act (ACA) expands insurance access, which is intended to improve access to care for the newly insured. But it is unknown whether the primary care system can handle the increased demand.

The authors sought to estimate a baseline for primary care access before the ACA coverage expansions took effect in January 2014. Trained field staff called primary care offices in Arkansas, Georgia, Illinois, Iowa, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania and Texas to ask about making a new patient appointment between November 2012 and April 2013. The callers posed as nonelderly adults with either private insurance, Medicaid or no insurance. A total of 12,907 calls were made to 7,788 primary care practices between November 2012 and April 2013.

Across the 10 states, 84.7 percent of the callers who said they had were able to get an appointment, as were 57.9 percent of callers claiming to have Medicaid coverage. Appointment rates were 78.8 percent for uninsured patients offering full cash payment but only 15.4 percent if the payment required at the time of the visit was $75 or less. Median (midpoint) wait times ranged from between five and eight days for private and Medicaid callers. About 75 percent of callers in both those patient groups were able to get a new-patient appointment in less than 2 weeks.

"Although most are accepting new , access varies widely across states and insurance status. … Tracking new patient appointment availability over time can inform policies designed to strengthen capacity and enhance the effectiveness of the coverage expansions with the Patient Protection and Affordable Care Act," Karin V. Rhodes, M.D., M.S., of the University of Pennsylvania Perelman School of Medicine, Philadelphia, and colleagues wrote in their JAMA Internal Medicine article.

More information: JAMA Intern Med. Published online April 7, 2014. DOI: 10.1001/jamainternmed.2014.20

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Reading 'Fifty Shades' linked to unhealthy behaviors

27 minutes ago

Young adult women who read "Fifty Shades of Grey" are more likely than nonreaders to exhibit signs of eating disorders and have a verbally abusive partner, finds a new study led by a Michigan State University ...

Emergency department nurses aren't like the rest of us

3 hours ago

(Medical Xpress)—Emergency department nurses aren't like the rest of us - they are more extroverted, agreeable and open - attributes that make them successful in the demanding, fast-paced and often stressful environment ...

Many patients don't understand electronic lab results

3 hours ago

(Medical Xpress)—While it's becoming commonplace for patients to see the results of lab work electronically, a new University of Michigan study suggests that many people may not be able to understand what ...

Healthier foods available in neighborhoods

4 hours ago

Changes to the federal food assistance program for low-income women and their children improved the availability of healthy foods at small and medium-size stores in New Orleans, according to research from ...

User comments