Despite millions of Americans purchasing health insurance through the Affordable Care Act (ACA), the start of 2014 saw a decline in new patient visits.

Recently, ACAView, a new report created by the Robert Wood Johnson Foundation, found that all specialties but pediatrics have experienced an overall decline in patient visits for 2014. However, as a percentage of total visits, Medicaid patient visits have increased.

The report has offered several hypotheses as to what has caused this downward trend. One possible explanation is that some newly insured patients may continue receiving care through emergency departments. It also may take time for new patients to establish a patient/provider relationship. Many patients are still playing catch-up after the rush to join at the end of the enrollment period and haven’t yet selected a physician. Although there are many possible explanations, it’s too soon to tell if this trend will continue.

While the ACA provides healthcare coverage for moderate-income Americans, Medicaid has initiated an eligibility expansion that provides access for those with a significantly lower income. Currently, 26 states have implemented the expansion, four states are considering the expansion, and 20 states have elected not to expand coverage. Since the start of 2014, Medicaid expansion has provided coverage for six million more Americans, representing a 10% increase in enrollment.

Physicians in states that have chosen to expand Medicaid eligibility have seen a substantial increase in the percentage of Medicaid patients, from 12.3% in 2013 to 15.6% in May of 2014. In states that haven’t expanded coverage, Medicaid patients increased less than 1%, from 5.9% to 6.4%.

Primary care, Ob/Gyn and surgery have all shown the most significant increase in Medicaid patient visits. When compared to states that chose not to expand, the number of Medicaid patients was up to three times higher. Hopefully, through continued observation in the coming months, we’ll have a better understanding of the various factors affecting these patient trends.

Author: Lauren Daniels

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