Primary Care Appointment Availability For New Medicaid Patients Increased After Medicaid Expansion In Michigan
Primary Care Appointment Availability For New Medicaid Patients Increased After Medicaid Expansion In Michigan
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DOI：
10.1377/hlthaff.2014.1425
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发表时间：
2015-08-01
期刊：
影响因子：
9.7
通讯作者：
Davis, Matthew M.
中科院分区：
文献类型：
--
作者：
Tipirneni, Renuka;Rhodes, Karin V.;Davis, Matthew M.
《平价医疗法案》将医疗保险覆盖范围扩大到数百万美国人，但新参保人口的医疗服务供应仍不确定。我们进行了一项模拟患者（或“秘密购物者”）研究，以评估2014年密歇根州医疗补助计划实施前后，医疗补助或私人保险新患者的初级保健预约可用性和等待时间。通过第1115条豁免而得以实现的扩展有一个独特的要求，即新的受益人必须在注册后60-90天内由初级保健提供者看到。在密歇根州的快速覆盖范围扩大期间，我们发现，与扩张前的可用性相比，新医疗补助患者的预约可用性增加了6个百分点，新私人保险患者的预约可用性下降了2个百分点。两组的等待时间保持稳定，均为1-2周。需要进一步研究来确定新参保患者获得初级保健的机会是否会随着时间的推移而持续。
The Affordable Care Act expands health insurance coverage to millions of Americans, but the availability of health care services for the newly insured population remains uncertain. We conducted a simulated patient (or "secret shopper") study to assess primary care appointment availability and wait times for new patients with Medicaid or private insurance before and after implementation of Michigan's Medicaid expansion in 2014. The expansion, which was made possible through a section 1115 waiver, has a unique requirement that new beneficiaries must be seen by a primary care provider within 60-90 days of enrollment. During a period of rapid coverage expansion in Michigan, we found that appointment availability increased 6 percentage points for new Medicaid patients and decreased 2 percentage points for new privately insured patients, compared to availability before the expansion. Wait times remained stable, at 1-2 weeks for both groups. Further research is needed to determine whether access to primary care for newly insured patients will endure over time.