New data shows primary care physicians and surgeons are collecting more in reimbursement since implementation of the Affordable Care Act, though reimbursement collection increases varied between states that did and did not expand Medicaid, according to the Robert Wood Johnson Foundation.
From 2013 to 2014, PCPs in states that did not expand Medicaid saw their collections increase 3.3 percent, while PCPs in states that did expand Medicaid saw collections increase by 3 percent.
For surgeons, collections increased by 4 percent in non-expansion states and by 2 percent in expansion states.
In non-expansion states, privately insured individuals ages 41 to 64 drove 57.1 percent of the increase in PCP revenues, while Medicare patients drove 41.4 percent. In expansion states, Medicaid patients ages 41 to 64 drove 46 percent of the increase in PCP revenues, while Medicare patients drove 39.4 percent.
Privately insured patients ages 41 to 64 were responsible for 51.1 percent of the revenue increase for surgeons in non-expansion states, while Medicaid patients in the same age group accounted for 72.9 percent of the increase in expansion states — reflecting a possibility that individuals were in need of surgery but had not had it until they gained Medicaid coverage, according to the report.
Although millions of Americans have gained medical insurance, the number of physician office visits has not increased dramatically as a result, according to the report. The number of surgical visits has increased only modestly, while the number of primary care visits to the same practice locations actually decreased.
"Despite the many disruptive changes associated with health reform, these data suggest that in terms of revenue growth for office-based physicians, so far it is largely a non-event," said Kathy Hempstead, who directs coverage issues at the Robert Wood Johnson Foundation. "Moderate declines in visits were offset by small increases in intensity of treatment and allowed amounts, and while the source of new patients in expansion versus non-expansion states differs greatly, the end result for physicians appears to be quite similar."
The data were compiled from nearly 20,000 physicians as part of the ACAView project, an ongoing effort by athenaResearch and Robert Wood Johnson Foundation to measure the impact of the ACA on the day-to-day practice of medicine.