Increased Health Coverage Will Not Overly Burden US Healthcare Delivery System

Despite concerns that increasing healthcare coverage for Americans through the Affordable Care Act (ACA) would lead to substantial strain on the US healthcare delivery system, a new report from The Commonwealth Fund found that increases will only modestly increase the demand for healthcare services.

The researchers project that only 7 states will experience increases in primary care visits that exceed 5% while the nation’s average is expected to be just 3.8%. This comes out to between 2.1 and 2.7 additional visits per week. The impact on specialists is expected to be even smaller.

The authors estimate that there will be an additional 20.3 million primary care visits as a result of the ACA. The newly insured through the ACA’s Marketplaces will account for more than a third of these primary care visits.

“We project that primary care providers will see, on average, 1.34 additional office visits per week, accounting for a 3.8% increase in visits nationally,” wrote Sherry A. Glied, PhD, dean of the Robert F. Wagner Graduate School of Public Service at New York University, and Stephanie Ma, a junior research assistant at the Wagner School of Public Service.

The Northeast will experience the smallest increase in primary care visits, while the South and West will see the largest increases. Outpatient departments in these 2 regions are expected to see growth of 5.7 and 7.3 visits a week per outpatient department, respectively.

Despite increases in visits, the authors do not expect worse access to care. This is because “high rates of primary care visits per physician did not always reflect low physician supply, since utilization rates depend on both the supply of doctors and the rate at which people use their services.”

For instance, in the Northeast there is a high supply of primary care doctors and insured residents make the fewest annual visits to primary care doctors.

“It is critical that the expansion of health insurance coverage leads to improved access to care for those who were previously uninsured and does not limit access for those who already have coverage,” the authors concluded. “Our results suggest that the current supply of primary care physicians and physicians in most specialties is sufficient to ensure this result will hold.”