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Practice Management > Building Your Business

Medical biller: PPACA may help physicians' patient mix

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The Patient Protection and Affordable Care Act (PPACA) seems to be increasing the odds that physicians’ patients will have health coverage without increasing the odds that the patients will have complicated health problems.

Analysts at athenahealth, a medical practice support services company, have published data supporting those conclusions in a summary of results from an analysis of 15,000 medical services providers that use athenahealth’s cloud-based practice management system.

The sample is not a random sample. The providers are less likely than the average provider to be working in a clinic affiliated with an academic medical center, and more likely to be located in the South. They are also comfortable enough with computers to be using a cloud-based practice management system.

But the company has been using its data to try to give PPACA watchers a rough idea of how PPACA is changing medical practices. In the latest report, the analysts look at year-over-year changes in practices’ new patients.

The new patients who appeared in 2014 were about as healthy as the new patients who showed up in 2013, the analysts say.

The percentage of new patients who had high blood pressure, for example, fell to 13.3 percent in 2014, from 13.4 percent in 2013, and the percentage who had diabetes held steady at 6.6 percent.

The percentage of all office visits by patients who lacked any form of insurance changed significantly, and more in the states that took PPACA Medicaid expansion money than in the non-expansion states.

See also: Indiana wins approval to expand Medicaid

In the expansion states, the uninsured rate for all office visits by adults ages 18 to 64 fell to 2.8 percent in 2014, from 4.6 percent in 2013.

In the non-expansion states, the uninsured rate for adults fell to 6.2 percent, from 7 percent.

Although the percentage of uninsured visits fell more in the Medicaid expansion states, the athenahealth figures suggest that the company’s practice management users were slow to accept new Medicaid patients.

See also: New Arkansas governor says state should keep Medicaid expansion

The percentage of office visits by adults ages 18 to 64 who had Medicaid coverage fell to 10.8 percent in the non-expansion states in 2014, from 11.2 percent in 2013. In the Medicaid expansion states, the share all visits involving working-age adults with Medicaid fell to 9 percent, from 9.2 percent.


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