U.S. primary care provider offices looked about the same after the big Patient Protection and Affordable Care Act (PPACA) health coverage changes took effect, in January 2014, as they did before the changes began.
The intensity of the typical office visit increased, but only about as fast as it was increasing before January 2014, according to analysts at the Robert Wood Johnson Foundation and athenahealth Inc., a medical billing company.
One measure for intensity is the average number of diagnoses per visit. The average number increased just 4.2 percent between 2013 and 2015, to 2.61. That’s down from a 5.5 percent rate of increase for the period from 2011 to 2013.
The analysts also studied patient visit and revenue-per-visit figures. The number of visits fell about 3 percent in 2014, after falling 2.4 percent in 2013. The average amount of revenue per visit increased 3.4 percent, to $100, from $96 in 2013.
The analysts based their figures on data from 21,900 medical practices that use athenahealth billing services. The sample included 4,900 primary care visits.
PPACA expanded access to Medicaid in many states starting in January 2014, and it provided subsidies that moderate-income uninsured people could use to buy health coverage through the new PPACA exchange system. Some observers predicted that coverage expansion would swamp physicians with new patients and hurt the quality of care.
The Robert Wood Johnson Foundation and athenahealth analysts found some evidence that more primary care physicians are accepting new patients with Medicaid.
In the Medicaid expansion states, 13 percent of the practices that saw no Medicaid patients in 2013 accepted new Medicaid patients in 2014, the analysts say.
Estimated visit times for the new patients with Medicaid were about the same as for patients with Medicare or commercial insurance.
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