scholarly journals Meeting the Demands of the Affordable Care Act: Improving Access to Primary Care

2017 ◽  
Vol 20 (2) ◽  
pp. 87-89 ◽  
Author(s):  
Peter M. McGough ◽  
Thomas E. Norris ◽  
John D. Scott ◽  
Tim G. Burner
Keyword(s):  
Primary Care ◽  
Affordable Care Act ◽  
The Affordable Care Act ◽  
Access To Primary Care

scholarly journals National and Regional Variation in Local Primary Care Physician Density Relative to the Uninsured and the Affordable Care Act

2019 ◽  
Vol 56 ◽  
pp. 004695801987380
Author(s):  
Barry C. Hill ◽  
Daniel Coster ◽  
David R. Black
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Affordable Care Act ◽  
Local Level ◽  
Care Physician ◽  
Medicaid Expansion ◽  
Physician Density ◽  
Before And After ◽  
The Affordable Care Act ◽  
Access To Primary Care

This study is the first to examine primary care physician (PCP) density relative to the uninsured at the local level prior to and after insurance expansion under the Affordable Care Act. Primary care physician density is associated with access to care, lower inpatient and emergency care, and primary care services. However, access to primary care among the uninsured may be limited due to inadequate availability of PCPs. Core-Based Statistical Area (CBSA) data from the Area Health Resource File were retrospectively examined before and after Medicaid expansion. Multiple logistic regressions were modeled for PCP density with predictor interaction effects for percentage uninsured, Medicaid expansion status, and US Census regions. Medicaid expansion CBSAs had significantly lower proportions of uninsured and higher PCP density compared with their nonexpansion counterparts. Nationally, increasing proportions of the uninsured were significantly associated with decreasing PCP density. Most notably, there is an expected 32% lower PCP density in Western Medicaid expansion areas with many uninsured (90th percentile) compared with those with few uninsured (10th percentile). Areas expanding Medicaid with greater proportions of people becoming insured postexpansion had significantly fewer PCPs. Areas with greater proportions of the uninsured may have reduced access to primary care due to the paucity of PCPs in these areas. Efforts to improve access should consider a lack of local PCPs as a limitation for ensuring accessible and timely care. Health care and policy leaders should focus on answers to improve the local availability of primary care clinicians in underserved communities.

Community-Oriented Primary Care (COPC) and the Affordable Care Act

2014 ◽  
Vol 6 (2) ◽  
pp. 128-133 ◽  
Author(s):  
Jaime Gofin ◽  
Rosa Gofin ◽  
Jim P. Stimpson
Keyword(s):  
Primary Care ◽  
Affordable Care Act ◽  
The Affordable Care Act

Intimate Partner Violence Screening Practices in California After Passage of the Affordable Care Act

2016 ◽  
Vol 23 (7) ◽  
pp. 871-886 ◽  
Author(s):  
Paula Tavrow ◽  
Brittnie E. Bloom ◽  
Mellissa H. Withers
Keyword(s):  
Primary Care ◽  
Intimate Partner Violence ◽  
Affordable Care Act ◽  
Low Income ◽  
Partner Violence ◽  
Intimate Partner ◽  
Cross Sectional Survey ◽  
Record Keeping ◽  
Screening Practices ◽  
The Affordable Care Act

Under the Affordable Care Act (ACA), insurance coverage should include screening for intimate partner violence (IPV). In this article, we present self-reported IPV screening practices and provider confidence from a post-ACA cross-sectional survey of 137 primary care clinicians in California. Only 14% of the providers reported always screening female patients for IPV and about one third seemed never to screen. Female providers were more likely to screen and use recommended direct questioning. Most providers lacked confidence in screening, referral, and record-keeping. Serving a low-income population predicted more frequent screening and better record-keeping. Overall, IPV screening in primary care was inadequate and needs attention.

scholarly journals HIV Screening and the Affordable Care Act

2016 ◽  
Vol 11 (2) ◽  
pp. 233-239 ◽  
Author(s):  
Greg Carter ◽  
Christopher Owens ◽  
Hsien-Chang Lin
Keyword(s):  
Primary Care ◽  
Affordable Care Act ◽  
Health Care Disparities ◽  
Primary Care Providers ◽  
Future Research ◽  
Hiv Screening ◽  
Health Providers ◽  
Care Providers ◽  
Increased Risk ◽  
The Affordable Care Act

Men continue to bear disproportionate accounts of HIV diagnoses. The Patient Protection and Affordable Care act aims to address health care disparities by recommending preventative services, including HIV screening, expanding community health centers, and increasing the healthcare workforce. This study examined the decision making of physician and primary care health providers to provide HIV screenings. A quasi-experimental design was used to estimate the effects of the Affordable Care Act on provider-initiated HIV screening. The National Ambulatory Medical Care Survey was used to examine HIV screening characteristic from two time periods: 2009 and 2012. Logistic regression indicated that patient and provider characteristics were associated with likelihood of being prescribed HIV screening. Non-Hispanic Black men were more likely to be prescribed HIV screening compared to non-Hispanic White men (odds ratio [OR] = 12.33, 95% confidence interval [CI; 4.42, 34.46]). Men who see primary care providers were more likely to be prescribed HIV screening compared to men not seeing a primary care provider (OR = 5.94, 95% CI [2.15, 16.39]). Men between the ages of 19 and 22 were more likely to be prescribed HIV screening compared to men between the ages of 15 and 18 (OR = 6.59, 95% CI [2.16, 20.14]). Men between the ages of 23 and 25 were more likely to be prescribed HIV screening compared with men between the ages of 15 and 18 (OR = 10.13, 95% CI [3.34, 30.69]). Health education programs identifying men at increased risk for contracting HIV may account for the increased screening rates in certain populations. Future research should examine age disparities surrounding adolescent and young men HIV screening.

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