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Obamacare Increased Collections, Decreased Visit Volume
Coverage expansions resulting from the Affordable Care Act have not had a negative financial effect on medical practices. Instead, primary care physicians reported increased collections and decreased visit volume, according to athenahealth
Higher reimbursement rates as a result of the Affordable Care Act have led to increased collections for primary care physicians (PCPs) in both Medicaid expansion and non-expansion states in 2014, according to a report from athenahealth and Robert Wood Johnson Foundation.
For PCPs in non-expansion states, collections increased 3.3% and in expansion states collections increased 3%. However, both groups saw a decrease in visit volume, although it was to a smaller degree in expansion states (0.3%) compared to non-expansion states (1.3%).
The insurance segments that drove collection increases differed in expansion and non-expansion states. In states that haven't expanded Medicaid, more than half (57%) of the increase in collections was attributed to commercially insured patients between the ages of 41 and 64 years. In both sets of states, Medicare was a primary driver of increased collections: the program accounted for 41.4% of the increase in non-expansion states and 39.4% in expansion states.
"Overall, our data suggests that the coverage expansion provisions of the ACA have not had a negative financial effect on medical practices," the authors of the report concluded.
New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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Integrated CKD Care Model Cuts ED Visits by 30%, Boosts Specialized Treatment
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