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From Health Affairs:


Michigan Medicaid Expansion Yields Primary Care Availability



Bethesda, MD -- The Affordable Care Act (ACA) offers millions of Americans who recently gained health insurance coverage the promise of increased access to care and improved health. However, the ready availability of primary care for the newly insured population--whether on Medicaid or through private insurance--is not known. One of the first studies of its kind, released today as a Web First by Health Affairs, examined the length of time new beneficiaries had to wait for primary care appointments in Michigan, a state that expanded eligibility for Medicaid in 2014. The study found that appointment availability increased 6 percentage points for new Medicaid patients and decreased 2 percentage points for new privately insured patients, compared to availability before expansion.  

Primary Care Appointment Availability For New Medicaid Patients Increased After Medicaid Expansion In Michigan


By Renuka Tipirneni, Karin V. Rhodes, Rodney A. Hayward, Richard L. Lichtenstein, Elyse N. Reamer, and Matthew M. Davis


Tipirneni, Hayward, Lichtenstein, Reamer, and Davis are affiliated with the University of Michigan, in Ann Arbor; Rhodes is with the University of Pennsylvania, in Philadelphia.


This study, also to appear in the August issue of Health Affairs, was supported by the Blue Cross Blue Shield of Michigan Foundation and the Robert Wood Johnson Foundation.


The study was modeled after the simulated patient study (or "secret shopper") approach recommended by the Department of Health and Human Services (HHS) to examine access to care for new Medicaid patients. Research team members, posing as new patients, called a random sample of approximately 300 primary care practices around the state before and after Michigan's April 1, 2014, expansion of Medicaid. "It is noteworthy that Medicaid appointment availability in Michigan increased rather than decreased during a period when approximately 350,000 adults entered the Medicaid system and the number of primary care providers likely remained stable," concluded the authors. They noted that it was not possible to conclude from this study if new patients with private insurance were being displaced by those with Medicaid, and called for further research to determine "whether increased access to care will persist in Michigan, and whether access to primary care for new patients with Medicaid in other states will follow similar patterns."

About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically at The full text of each Health Affairs Web First paper is available free of charge to all website visitors for a one-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund. You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download our podcasts, including monthly Narrative Matters essays, on iTunes. Tap into Health Affairs content with the new iPad app.