Early days of Obamacare Bring Trickle, Not Flood, of Patients

Reuters News Service
January 4, 2014
Early days of Obamacare Bring Trickle, Not Flood, of Patients

By Sharon Begley and Lewis Krauskopf

NEW YORK, Jan 4 (Reuters) - U.S. medical providers are seeing only a trickle of patients newly
insured under President Barack Obama's healthcare law, as insurers, hospitals and doctors try to
work out any hitches in coverage.

More than 2 million people have signed up for new private health plans that took effect on
Wednesday under the Affordable Care Act, popularly known as Obamacare. While some of those
consumers were already lining up doctor visits last month, early reports from providers and an
online medical booking service show the demand for care has been modest so far.

Within the Obama administration, officials fear a surge of patients in the coming weeks could
spotlight cases where consumers who signed up for insurance can't immediately get care due to
technical failures on the government's HealthCare.gov enrollment website.

Already on Friday, Senate Republicans opposed to the law seized on scattered media reports of a
handful of people having difficulty confirming their new insurance policies, feeding into a narrative of
Obamacare's harms that is expected to intensify ahead of Congressional elections in November.
Central Ohio Primary Care, a 250-physician practice, is holding off on filing claims for patients who
say they bought plans through the HealthCare.gov exchange, said Chief Executive Officer Dr.
William Wulf.

The delay will allow insurers more time to confirm membership information and avert any erroneous
claim denials, Wulf said.

Such a grace period "surely is not desirable long term," he said, but the number of patients with
Obamacare plans has so far been low and represents only a small fraction of the practice's patients.
"What we're doing is we're seeing the patients, trusting they are in fact going to pay for insurance
and just not sending a bill yet," Wulf said.

Contrary to fears that Obamacare enrollees would be sicker than other Americans, with serious and
expensive pent-up medical needs, so far they are not much different from other Americans,
according to data from ZocDoc, a six-year-old closely held company that allows patients to find a
doctor who accepts their insurance and make an appointment online.

Obamacare consumers "started booking appointments the last two weeks of December for January
appointments," said ZocDoc founder and Chief Operating Officer Dr. Oliver Kharraz. "The vast
majority of these were for preventive care, not acute care where people indicated they had an
existing illness, which accounted for only 7 percent of searches."

That mirrors the behavior of ZocDoc's previously insured users. ZocDoc says the site gets just over
5 million unique visitors each month who are searching doctors' ratings and reviews as well as
making appointments.

As many as 7 million people are expected to sign up for the new health plans, which include
government subsidies for lower-income households, by the time 2014 enrollment ends on March 31.

Of course, some newly insured people were anxious to get care almost as soon as the last strains
of Auld Lang Syne petered out.

One customer of North Shore-LIJ CareConnect, a new insurer selling plans on the New York State
of Health marketplace, went to its customer center last month, paid cash for a policy, "and asked if
he could now schedule his son's gastric bypass," said Chief Executive Officer Alan Murray.

In the case of another CareConnect customer, last month her doctor arranged for her to have
surgery for recently diagnosed endometrial cancer as soon as possible. The insurer approved it in
December, before her coverage even kicked in, the surgery was successfully performed on Jan. 2,
and the woman was discharged from the hospital on Friday.

Insurers also heard from unusually high numbers of new customers anxious to confirm their

On Jan. 1, Philadelphia-based Independence Blue Cross received eight times as many calls as a
typical New Year's Day from consumers most commonly seeking to confirm that they were indeed
covered, said Brian Lobley, senior vice president of marketing and consumer business.

"We haven't seen any systemic issues" of Independence's newest members having trouble
confirming their policies, he said.

Because medical practices often do not file insurance claims daily, he added, it is too early to draw
any conclusions about use of medical services with the new plans.

On ZocDoc, people with Obamacare insurance searched most frequently for primary care
physicians, accounting for more than half of all searches, said Kharraz, followed by
obstetricians/gynecologists and dermatologists. That is identical to the most-searched-for categories
for people with non-Obamacare coverage, he said.

Hospitals expect Obamacare to bring them more paying patients and reduce the amount of
uncompensated care they provide, but have not seen a surge yet.

"We continue to expect an uptick in volume, but we don't think it's anything beyond what most
hospitals are prepared to handle," said Jeff Goldman, vice president of coverage policy for the
American Hospital Association

Pharmacists are not reporting a surge in demand either. "At this time, activity is fairly typical of what
we experience each year when insurance changes take effect," said Walgreen Co spokeswoman
Markeisha Marshall. "Nonetheless, we anticipate a surge of activity next week."


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