5 ways the PPACA has impacted physicians

A new report shows that one year after the Patient Protection and Affordable Care Act's coverage expansion provisions took effect, physicians have not been overwhelmed by new patients scheduling appointments.

The report, a joint effort between the Robert Wood Johnson Foundation and athenahealth, examines how the first year of the health law impacted U.S. physician practices, and draws upon near real-time data from a subset of athenahealth's cloud-based network of more than 62,000 healthcare providers and 62 million patients.

The report reveals the following:

1. The proportion of new-patient visits to primary care providers only slightly increased, from 22.6 percent in 2013 to 22.9 percent in 2014.

2. The proportion of visits for comprehensive evaluation and management of new patients, including taking a patient history, conducting a physical exam and making medical decisions, increased from 6.7 percent in 2013 to 7 percent in 2014.

3. There was no evidence that patient complexity went up in 2014. Physician work intensity per visit remained flat, diagnoses per visit increased slightly, and the percentage of visits with high-complexity evaluation and management codes actually decreased slightly, according to the report.

4. The PPACA has decreased the overall proportion of uninsured patients receiving care in physician offices, especially in Medicaid expansion states. From 2013 to 2014, the proportion of visits by uninsured patients in Medicaid expansion states fell from 4.6 percent to 2.8 percent, while the proportion of visits by uninsured patients in nonexpansion states fell from 7 percent to 6.2 percent.

5. The health law has substantially changed physician payer mix. In nonexpansion states, the proportion of visits from commercially insured patients increased from 72 percent to 74 percent. In expansion states, the proportion of visits from Medicaid patients surged from 12.8 to 15.6 percent.


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