Report: Primary Care Access Increased for Medicaid Patients after Expansion in 2014

Crain's Detroit Business
June 17, 2016
Dr. Karin Rhodes, VP, Care Management Design & Evaluation, Northwell Health Office of Population Health, and Hofstra Northwell School of Medicine

Despite concerns that newly insured patients in Michigan might not have access to primary care providers, a new study by University of Michiganresearchers concludes primary care appointment availability for new Medicaid patients increased in the first year after the state expanded Medicaid in April 2014.
"We found an initial increase in primary care appointment availability for new Medicaid patients with no lengthening of wait times four months after expansion," said the report published in the June issue of the American Journal of Managed Care.
As Healthy Michigan Medicaid expansion continued during the first year to ultimately add 600,000 people to the Medicaid rolls, which represented 57 percent of the previously uninsured population, another 340,000 people purchased private insurance through the state health insurance exchange, an interesting trend developed.
Medicaid patients found it easier to make appointments during the next 12-month period after April 2014 than before expansion. The percentage of clinics accepting new Medicaid patients increased to 55 percent one year after Medicaid expansion compared with 49 percent before. But private insurance policyholders experienced a slight tightening of clinics accepting new patients, dropping to 86 percent one year after compared with 88 percent before. The data clearly shows, however, that privately insured patients still have more access than Medicaid patients.
However, Medicaid and private health insurance purchasers found much greater access with nonphysician providers during those periods of time.
The study found 21 percent of Medicaid patients received new appointments with nonphysician providers one year after Medicaid expansion compared with 8 percent before expansion.
Also, 19 percent of private insurance purchasers obtained new appointments with nonphysicians compared with 11 percent before.
"One year following Medicaid expansion in Michigan, appointment availability for new Medicaid patients stably increased," the report said. "This is perhaps attributable to increasing proportions of appointments scheduled with nonphysician providers."
Study authors at the University of Michigan were Renuka Tipirneni, M.D.; Karin Rhodes, M.D.; Rodney Hayward, M.D.; Richard Lichtenstein; HwaJung Choi; Elyse Reamer; and Matthew Davis, M.D. Also contributing was Karin Rhodes, M.D., of Hofstra Northwell School of Medicine in Hempstead, N.Y.
Hofstra Northwell Medical School (KVR), Great Neck, NY. - See more at: http://www.ajmc.com/journals/issue/2016/2016-vol22-n6/primary-care-appoi...
The study was funded by Blue Cross Blue Shield of Michigan Foundation and the Princeton, NJ.-based Robert Wood Johnson Foundation.
Hofstra Northwell Medical School (KVR), Great Neck, NY. - See more at: http://www.ajmc.com/journals/issue/2016/2016-vol22-n6/primary-care-appoi...

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