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Life Health > Long-Term Care Planning

Provider supply can stretch

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Health care providers might be able to expand the supply of care quickly and easily – if regulators encourage use of nurse practitioners and other mid-level health professionals.

Three economists – Thomas Buchmueller, Sarah Miller and Marko Vujicic – come to that conclusion in an informal working paper published behind a paywall on the National Bureau of Economic Research’s website.

Buchmueller, a professor at the University of Michigan business school, and his colleagues, studied the flexibility of the supply of health care in this country by looking at what happened when some states dramatically expanded access to Medicaid dental benefits.

The economists found dentists were able to provide care for the newly insured patients, and earn more money without working significantly more hours, by hiring dental hygienists.

Because hiring hygienists was so effective at amplifying the supply of care, a 10-percentage-point increase in the number of people with coverage translated into an increase in typical appointment wait times of just 0.7 days, the economists found.

The economists say the supply of care expanded more smoothly in states that let hygienists bill Medicaid directly.

In states in which hygienists could not bill Medicaid directly, offering dental coverage to adult Medicaid enrollees led to a 16 percent increase in the average appointment wait time for established dental practice patients.

The economists say their study could have implications for how the Patient Protection and Affordable Care Act will affect the supply of medical care and access to medical care.

One way to keep PPACA coverage access expansion from leading to increased appointment wait times is to ease access to nurse practitioners, especially at the primary care level, the economists say.

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