Difference of Treatment Between Primary and Private Care

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Though many more Americans are now insured due to the Affordable Care Act (ACA), their access to basic healthcare still primarily depends on the type of insurance plan they have and their location.

A recent study by the Journal of the American Medical Association (JAMA) showed that those patients with Medicaid or ACA insurance plans have a difficult time securing primary care appointments; priority is given to patients who have private insurance. Approximately one third of Medicaid insured adults who aren’t considered elderly live in Arkansas, Georgia, Illinois, Iowa, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania and Texas. The study involved calling primary care practices in those states and attempting to make appointments.

Callers with private insurance had a success rate of 85%, whereas only 58% of Medicaid insured callers were successful. Uninsured callers were successful 79% of the time if they could pay in cash in advance. For those who were able to only make a minimum payment in advance, the success rate reduced to 15%.

The goal of healthcare reform has been to provide coverage for all and improve the American healthcare system. However, if Americans are unable to access primary care, the system won’t be able to proceed with its goals for improvement. As more and more people enroll in ACA healthcare plans, this is an issue that will need to be addressed immediately.

Author: Apoorva Anupindi

2 thoughts on “Difference of Treatment Between Primary and Private Care

  1. These are initial first few months since ACA insured are seeking medical help in the market. These 7 or 8 Million newly insured people are certainly adding pressure on the existing infrastructure of healthcare facilities. As in any business, obviously, clinics are paying more attention to high paying customers or patients. This is especially felt in the belt where there are large number of ACA insured, who are seeking help. Let’s give some time, a few months, may be a couple of years to allow the entire primary healthcare echo systems to adjust to new normal. This also involves encouraging more doctors to take primary care as profession and support these additional insured folks.

  2. I’ve been hearing a lot about a coming shortage of primary care doctors because their reimbursement rates are so much lower than specialists. Have also heard about shortages of funding for medical students education.

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