Access to Care
- Although the Affordable Care Act will grant Medicaid to nearly 17 million new enrollees, new research suggests that supply-side reforms are needed to ensure adequate access to health care for both public and private paying patients. The Children’s Health Insurance Program (CHIP) was used as a model to analyze the impact of the ACA on expanding public coverage and increasing physician reimbursement.
- Increasing the public’s access to care is only the tip of the iceberg. There are non-financial barriers (e.g. availability and affordability) that have been proven to be common reasons for unmet need or delayed care.
- What’s access without availability? 32 million Americans stand to gain access to health coverage, but without an appreciable increase in health care providers will physicians and hospitals serve as bottlenecks in our system?
- Except under the circumstances of emergencies with labor and delivery, undocumented immigrants in the US do not have coverage under the ACA. In Belgium, where everyone has coverage, they have been able to find strong inverse correlations between naturalization and perinatal mortality.
- CHIP has been very effective in providing healthcare coverage to children whose families would otherwise be unable to afford private insurance coverage. It has been such a success, that many have used it as a model to see what adult coverage will look like when the ACA is fully unveiled in 2014.
- Reducing the approval time of health coverage for disability insurance beneficiaries improves self-reported physical and mental health, but does not necessarily reduce emergency room visits or return to employment.
- While some states continue to refuse the ACA’s Medicaid expansion provision, Medicaid expansion in other states have seen an increase in self-reported good health and decreases in uninsurance rates, delay of care, and mortality rates among low-income adults.
- Some subspecialty physicians can make up to $3 million more over their lifetime than primary care physicians. As this difference in income is no competition with primary care loan forgiveness programs and Medicaid/Medicare reimbursements, more physicians are choosing subspecialties over primary care.
- Often lost in the debate of the uninsured, those who are homeless and or with mental illness will reap benefits from improved access to care.
- With the increasing population of those 60 years and older as well as increases in prevalence of cardiovascular disease and obesity; cardiovascular physicians and, thus, their services will be needed more than ever.
- If Massachusetts is the harbinger, then the ACA is off to a good start. Save for cost control, Massachusetts has seen improvements in insurance coverage and even the health status of its residents.
- Gym membership may not only be great for your overall health, it may also reap long term financial benefits for your health insurer’s bottom line. When the Affordable Care Act is fully implemented by 2014, the process of insurers “cherry-picking” healthier customers will be outlawed. However, insurers still have tricks up their sleeves to attract healthier individuals to their Medicare Advantage programs.
by
Nii Darko, DO, MBA and Renée Volny, DO, MBA
