Study Predicts Health Reform Will Increase Need for Primary Care Providers

Expansion of health care coverage mandated by health reform will push demand for primary care providers sharply upward, and thousands of new physicians are needed to accommodate the increase, a new study finds.

“Health care consumers should expect that in the period immediately following the coverage expansion, they may experience some difficulties getting timely appointments. It really depends where they are located geographically and how quickly those who obtain coverage pursue care,” Jean Marie Abraham, PhD, study co-author, stated in a press release.

Using 2006 and 2007 data from the Medical Expenditure Panel Survey, a survey that included 33,768 adults and 17,572 children, and other sources, Abraham and colleagues predicted state-by-state annual increases in primary care visits as the result of the Patient Protection and Affordable Care Act, passed into law in 2010. The legislation extends health care coverage to an estimated 32 million uninsured people in the United States.

Overall, the authors expect the number of annual primary care visits to rise by about 15 million to 24 million visits by 2019. These increases only take into account the health care coverage expansion, not other factors that may increase annual primary care visits, such as the aging population, the authors stated.

“Places that have a high percentage of uninsured will have the biggest increase in demand and will experience the biggest shock to the delivery system,” Abraham, a health economist and assistant professor at the University of Minnesota School of Public Health, stated.

Of the states, California, Texas and New York will experience the largest increases in demand and use of providers, according to the study, which appears in the latest issue of the journal The Milbank Quarterly.

For consumers, the effect of expanded coverage differs depending on perspective.

“If you have wanted to get insurance and couldn’t get it, it’s good news. If you have health insurance and an established relationship with a physician, you won’t see any change. If you are looking for a new primary care physician, you may find longer waits,” Robert Field, PhD, a professor at the Drexel University School of Public Health in Philadelphia not affiliated with the study, stated.

To cover the increases, the authors predicted that between 4,307 and 6,943 more primary care physicians will be necessary.

However, Field said, “They don’t take into account the number of positions that will be filled by non-physician clinicians, such as nurse practitioners and physician’s assistants. We’ll undoubtedly be seeing more of that.”

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