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Study finds access to healthcare remains problematic through ACA and commercial insurance plans

In the United States, ACA Marketplaces lack network adequacy. Improving access to affordable health insurance, and by extension, to care, is one of the main goals of the Affordable Care Act (ACA).  In the price-competitive ACA Marketplaces, plans with relatively narrow provider networks have proliferated.

To find out how this affected access to care, Simon Haeder, assistant professor of political science, and his research team used a “secret shopper” survey of 743 primary care providers from five of California’s nineteen insurance Marketplace pricing regions in 2015.  

They found that inaccurate and outdated provider information and a resistance to new patients were commonplace, both inside and outside California’s Marketplace, with only about 30 percent of efforts to make an appointment with a specific primary care physician ending in success. The authors conclude that more frequent updating (California currently requires quarterly updates), potentially coupled with incentives and penalties for both providers and insurers, might be the only path to improved access for patients.

Haeder’s study was published in the July issue of Health Affairs. 

Photo credit: Alex Prolmos