Possible Affordable Care Act Glitch: Too Few Doctors

Study suggests 'safety-net' practices may not absorb everyone covered under new system

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FRIDAY, Nov. 30 (HealthDay News) -- Many doctors who would be most likely to care for patients who become newly insured under the Affordable Care Act may not accept new patients, according to a recent study.

Under the act, it is expected that up to 50 million currently uninsured people will get some type of health insurance coverage.

Doctors who currently care for a large number of uninsured or Medicaid-covered patients are known as "safety-net physicians." Many people who become newly insured under the Affordable Care Act are likely to turn to these doctors, according to the researchers at the Mongan Institute for Health Policy at Massachusetts General Hospital in Boston.

Their study suggests, however, that these doctors may not accept new patients.

The researchers looked at a 2009 survey of 840 primary-care doctors. Of those, 53 percent were safety-net providers, which means that more than 20 percent of their patients were either uninsured or covered by Medicaid.

Half of all the doctors in the survey said they were accepting new patients who were uninsured or covered by Medicaid. Safety-net doctors, however, were much more likely to accept both types of patients, with 72 percent taking new Medicaid patients and 61 percent taking new patients with no insurance.

Study authors noted that the care of Medicaid and uninsured patients is concentrated among a limited number of safety-net physicians and that 28 percent of safety-net doctors who treat Medicaid patients and 39 percent of those who treat uninsured patients are no longer accepting new patients. This suggests that the current health care safety net may have reached its capacity.

"This study raises very serious concerns about the willingness and ability of primary-care providers to cope with the increased demand for services that will result from the [Affordable Care Act]," study senior author Eric Campbell said in a hospital news release. "Even with insurance, it appears that many patients may find it challenging to find a physician to provide them with primary-care services."

The researchers said strategies designed to increase the number of safety-net physicians and provide them with more support could help ensure that newly covered patients have access to primary care.

The study appeared online Oct. 12 in the American Journal of Medical Quality.

More information

The Centers for Medicare and Medicaid Services has more about Medicaid.

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