Will There Be Enough Providers to Meet the Need? Provider Capacity and the ACA

 A line of waiting patients in a clinic.

A report funded by the Robert Wood Johnson Foundation, as part of the Affordable Care Act (ACA) Implementation--Monitoring and Tracking series, examines the capacity of providers to deliver timely, quality care to the newly insured in 10 case study states. Under the ACA, upwards of 30 million individuals are expected to gain coverage either through Medicaid expansions or subsidized coverage in health insurance exchanges. The report finds that many stakeholders are concerned about the nation’s capacity to serve the newly insured, particularly among primary care providers.

Key Findings

  • Increasing primary care reimbursement rates may help to maintain providers' participation in programs like Medicaid or, at the least, may slow departures from the program.

  • Federally Qualified Health Centers are well positioned to play a key role in meeting new demand for services among individuals and families gaining coverage under health reform.

  • Though there was not an abundance of activity in the study states aimed at expanding the workforce, a few states offer medical school loan forgiveness in return for commitments to practice in underserved areas.

  • There has been considerable activity in the private sector and in public programs to contain costs, improve quality, and increase access to care. Multiple states are even implementing Accountable Care Organization-type initiatives as well as medical home initiatives and consumer-operated and oriented plans.

This report is one of a series of reports focusing on ACA implementation issues uncovered in Alabama, Colorado, Maryland, Michigan, Minnesota, New Mexico, New York, Oregon, Rhode Island and Virginia.

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