Demand still uncertain from newly insured

Some health systems and clinics around the country reported a flood of phone calls as newly insured patients started seeking care following the Jan. 1 effective date of their Obamacare coverage. But they said it's too soon to know the impact on demand for services.

More than 2.1 million people have signed up for coverage through the federal and state insurance exchanges, and another 3.9 million qualified for Medicaid, according to HHS. The rollout and volume of enrollments have been uneven by state.

Providers are reporting few problems with new patients despite lingering concerns that technology glitches will mean that many Americans will find out when they seek care that they don't actually have coverage.

At MemorialCare Health System in Long Beach, Calif.—a state with one of the most successful state-run exchanges—physician practices are receiving a “barrage of phone calls,” CEO Barry Arbuckle said. Most of the calls are from current patients checking to see whether their new plan is accepted. But a growing number are from new patients.

In response, MemorialCare has expanded the number of outpatient centers where it sees patients and ramped up staffing at its retail clinics and urgent-care centers. At one practice, which opened last year in a former Borders' bookstore with six physicians, it has added 10 primary-care physicians in anticipation of increased demand. MemorialCare also trained its staff members to field increased questions about which health plans are accepted and how to handle patients who may have signed up for coverage but don't yet have their cards.

Texas Health Resources—in a state with the nation's highest rate of uninsured people—is anticipating a modest increase in volume because of insurance expansion. But a spokesman said it is too early to assess the impact. State Republican officials declined to expand Medicaid eligibility and have put up barriers to enrollment efforts. Texas Health Resources is in-network for some of the new plans being offered on the federal exchange, but not all of them, the spokesman said.

In Ohio, another state that's being served by the federal exchange, enrollment picked up steam. The Neighborhood Health Association, a community health center that has 16 enrollment navigators in Toledo and is the second largest grantee in the state, has fielded about 30 calls and sees about 75 to 90 consumers each day. On the last day of enrollment for Jan. 1 coverage, it had 100 sign-ups.

Despite a snowy and bitter cold start to the year, the health center's nine clinics experienced increased demand. The center also has conducted follow-up calls with individuals who have enrolled in insurance plans. “We've been rolling very smoothly,” said Brad Clark, navigator project director. “We have not had any feedback (about problems with plans).”

It was business as usual at Healthcare Associates in Medicine in Staten Island, N.Y., which offers specialties such as orthopedics, neurology and pain management. Paul Berkeley, administrator and CEO at Healthcare Associates, said the practice hasn't seen any impact yet from insurance expansion, even at its walk-in orthopedic clinics. New York has made a significant push to enroll individuals into commercial and Medicaid managed-care plans, with about 242,000 signed up.

Yet Berkeley said he is concerned about the number of patients who will come in with a high-deductible health plan and have 90 days to pay their bills—leaving practices on the hook for fees in the meantime.

An unscientific survey by the Americans Academy of Family Physicians of its members found that 23% of doctors said they had seen an increase in patients since Jan. 1, though most said they saw no change in patient traffic.

Follow Beth Kutscher on Twitter: @MHbkutscher