At the same time the Affordable Care Act increased the number of insured Americans, analysis of health care industry data shows a continued decline in contact with primary care physician services. The study applied an "ecology of medical care" framework analysis to a national dataset of Americans' contact with the US medical care system. Tracked services included visits and calls to physicians, including primary care and sub-specialty physicians, emergency departments, inpatient hospitalizations, dental visits and home health visits. Analysis showed a drop in the uninsured rate post-Affordable Care Act, from 12.8% in 2013 to 7.6% in 2016. Between 2002 and 2016, patients were overall less likely to see a primary care physician, be hospitalized, or receive dental care. However, contact with home health visits increased. Despite the increase in insurance coverage, the Affordable Care Act appeared to have had minimal effect on the trend of decreasing primary care contact in the general population during the first two years after implementation.
The Ecology of Medical Care Before and After the Affordable Care Act: Trends From 2002-2016
Michael E. Johansen, MD, MS, et al.
Ohio Health, Grant Family Medicine, Columbus, Ohio
The Annals of Family Medicine