So much for the new patient surgeNews added by Benefits Pro on July 21, 2014

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By Britt Chester

A new Athenahealth study offers some startling insight into the effect the Patient Protection and Affordable Care Act has had on new patient visits: There isn’t the surge industry professionals predicted.

According to Athenahealth’s ACAView, which provides "timely, non-partisan measurement and analysis of how coverage expansion under the Affordable Care Act affects the day-to-day practice of medicine,” there has been little change in the amount of new patient visits to primary care, pediatric, OB/GYN, surgery and “other” medical facilities.

Athenahealth’s research was commissioned by Robert Wood Johnson Foundation. Because the company offers cloud-based services for medical providers, they were the primed for conducting the research based on their access. The study focused on roughly 14,300 doctors serving 5.8 million patients who saw over 12 million patient visits.

In some cases, like that of primary care practices, the amount of new patient visits between January and May from 2013 to 2014 dropped by roughly .5 percent. Pediatrics was the only practices that actually saw a rise, while surgeries maintained the same amount of new patient visits in the selected duration.

In fact, another startling conclusion based on the report shows that even though states with greater enrollment in the new health insurance exchanges showed a decrease in new patient visits. The assumption, and an argument for PPACA, was that with more Americans covered under new insurance plans, medical offices would see a significant increase in new patients. Primary concerns focused around newly insured individuals who would be seeking care for illnesses and ailments that would have normally proceeded untreated.

As this study merely shines a spotlight on the first five months of the calendar year, Athenahealth is quick to that there are certain variables at play depending on the geography. For instance, severe weather and a lack of reliable transportation in certain parts of the country could affect the decision to seek care. Also, the major surge in new coverage for people under PPACA also might affect new patient visits because the populace is shopping options for physicians.

Another offered explanation in the report concludes that some individuals might still be visiting the emergency department at area hospitals to receive treatment for an illness that not require emergency care rather than finding a physician in under the network coverage of their new provider.

Contradicting assumptions that new patients would require more attention because of untreated medical problems, the study also found that new patients were actually, in more cases than not, healthier.

Another noteworthy finding was that “[PPACA] coverage appears to be widening a pre-existing gap between states that have elected to pursue Medicaid expansion and those that have not.” What PPACA was attempting to do was offer expanded coverage through two possible outcomes. The first being that “people with moderate incomes could gain coverage through the exchanges…others with lower incomes could gain coverage through the expansion of Medicaid eligibility to include groups that had not traditionally qualified for Medicaid.”

While some states did expand their Medicaid coverage to include more of its populace, most didn’t. The changes over the five-month period were of little note for those remaining uninsured, though, for new patient visits.

Athenahealth was founded in 1997 by Jonathan Bush and Todd Park, who ran a birthing center in California. Athenahealth’s initial services were cloud-based data that would relieve medical practices of the painstaking paperwork involved with business operations.

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