But that is not what they found. Though it may seem counterintuitive, the organizations discovered that during the first five months of 2014, all specialties—with the exception of pediatrics—experienced lower rates of new-patient visits than they had in the year-ago period. This was based on data taken from more than 14,000 providers across specialties.
For example, the proportion of visits from new patients to primary-care physicians in the sample from January to May 2014 was 18.8% compared with 19.3% during that same five-month period in 2013.
The study did not analyze what caused this decline, but the authors suggest that one reason is that the newly insured are continuing to go to emergency departments instead of physician offices. That explanation seems consistent with studies that showed increased emergency department use after pre-ACA expansions of health insurance in Massachusetts and Medicaid in Oregon.
“It's not unexpected at all,” said Stephen Zuckerman, co-director and a senior fellow in the Health Policy Center of the Urban Institute. “Given what we know from survey data, people are quite confused about a lot of the basic features of health insurance plans. This is true for people who have had insurance, and it's even more of an issue for people who are becoming newly insured.”
In an analysis released Tuesday, more than 80% of outreach programs surveyed by the Kaiser Family Foundation said consumers seeking their assistance didn't understand or were confused by the Affordable Care Act. And nearly three quarters of people coming to them for help had difficulty understanding basic insurance concepts, including deductibles or provider networks.
Health insurers say they have known this for a long time and have been dealing with it well before the Affordable Care Act went into effect, according to Susan Pisano, spokeswoman for the trade organization America's Health Insurance Plans.
“We as a community have been very focused on health literacy as an endeavor within the industry,” Pisano said. “But it's been amped up.”
Outreach and educational efforts from AHIP's members have included new-member kits, outbound calls to newly insured individuals, webinars, reminders for gender- and age-specific preventive coverage, and the use of multi-language materials and interpreters.
“We have been making new-member calls for as long as I can remember,” said Ed Harden, spokesman for McLaren Health Plan, based in Flint, Mich. “Every new member we enroll gets a call to welcome them to the plan and ask if they have any questions, if they've selected a primary-care physician and to coordinate scheduling an appointment for them if they need one immediately.”
McLaren also distributes newsletters, operates a website with educational information and assists members in getting enrolled in disease management programs and health counseling services.