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Coverage Expansions and Utilization of Physician Care: Evidence From the 2014 Affordable Care Act and 1966 Medicare/Medicaid Expansions.

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Title: Coverage Expansions and Utilization of Physician Care: Evidence From the 2014 Affordable Care Act and 1966 Medicare/Medicaid Expansions.
Authors: Gaffney, Adam (AUTHOR), McCormick, Danny (AUTHOR), Bor, David (AUTHOR), Woolhandler, Steffie (AUTHOR), Himmelstein, David (AUTHOR)
Source: American Journal of Public Health. Dec2019, Vol. 109 Issue 12, p1694-1701. 8p.
Subjects: Patient Protection & Affordable Care Act, Medical care use, Medicare, Medicaid, Medical care of poor people, Physicians
Geographic Terms: United States
Abstract: Objectives. To evaluate the effects of the 2 major coverage expansions in US history—Medicare/Medicaid in 1966 and the Affordable Care Act (ACA) in 2014—on the utilization of physician care. Methods. Using the National Health Interview Survey (1963–1969; 2011–2016), we analyzed trends in utilization of physician services society-wide and by targeted subgroups. Results. Following Medicare/Medicaid's implementation, society-wide utilization remained unchanged. While visits by low-income persons increased 6.2% (P <.01) and surgical procedures among the elderly increased 14.7% (P <.01), decreases among nontargeted groups offset these increases. After the ACA, society-wide utilization again remained unchanged. Increased utilization among targeted low-income groups (e.g., a 3.5-percentage-point increase in the proportion of persons earning less than or equal to 138% of the federal poverty level with at least 1 office visit [ P <.001]) was offset by small, nonsignificant reductions among the nontargeted population. Conclusions. Past coverage expansions in the United States have redistributed physician care, but have not increased society-wide utilization in the short term, possibly because of the limited supply of physicians. Public Health Implications. These findings suggest that future expansions may not cause unaffordable surges in utilization. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Coverage Expansions and Utilization of Physician Care: Evidence From the 2014 Affordable Care Act and 1966 Medicare/Medicaid Expansions.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22American+Journal+of+Public+Health%22&quot;&gt;American Journal of Public Health&lt;/searchLink&gt;. Dec2019, Vol. 109 Issue 12, p1694-1701. 8p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Patient+Protection+%26+Affordable+Care+Act%22&quot;&gt;Patient Protection &amp; Affordable Care Act&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+care+use%22&quot;&gt;Medical care use&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medicare%22&quot;&gt;Medicare&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medicaid%22&quot;&gt;Medicaid&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+care+of+poor+people%22&quot;&gt;Medical care of poor people&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Physicians%22&quot;&gt;Physicians&lt;/searchLink&gt;
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  Data: Objectives. To evaluate the effects of the 2 major coverage expansions in US history—Medicare/Medicaid in 1966 and the Affordable Care Act (ACA) in 2014—on the utilization of physician care. Methods. Using the National Health Interview Survey (1963–1969; 2011–2016), we analyzed trends in utilization of physician services society-wide and by targeted subgroups. Results. Following Medicare/Medicaid&#39;s implementation, society-wide utilization remained unchanged. While visits by low-income persons increased 6.2% (P &lt;.01) and surgical procedures among the elderly increased 14.7% (P &lt;.01), decreases among nontargeted groups offset these increases. After the ACA, society-wide utilization again remained unchanged. Increased utilization among targeted low-income groups (e.g., a 3.5-percentage-point increase in the proportion of persons earning less than or equal to 138% of the federal poverty level with at least 1 office visit [ P &lt;.001]) was offset by small, nonsignificant reductions among the nontargeted population. Conclusions. Past coverage expansions in the United States have redistributed physician care, but have not increased society-wide utilization in the short term, possibly because of the limited supply of physicians. Public Health Implications. These findings suggest that future expansions may not cause unaffordable surges in utilization. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=139529088
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.2105/AJPH.2019.305330
    Languages:
      – Code: eng
        Text: English
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      Pagination:
        PageCount: 8
        StartPage: 1694
    Subjects:
      – SubjectFull: Patient Protection & Affordable Care Act
        Type: general
      – SubjectFull: Medical care use
        Type: general
      – SubjectFull: Medicare
        Type: general
      – SubjectFull: Medicaid
        Type: general
      – SubjectFull: Medical care of poor people
        Type: general
      – SubjectFull: Physicians
        Type: general
      – SubjectFull: United States
        Type: general
    Titles:
      – TitleFull: Coverage Expansions and Utilization of Physician Care: Evidence From the 2014 Affordable Care Act and 1966 Medicare/Medicaid Expansions.
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            NameFull: Gaffney, Adam
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            NameFull: Bor, David
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            – D: 01
              M: 12
              Text: Dec2019
              Type: published
              Y: 2019
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              Value: 109
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              Value: 12
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