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No rush to pricey specialists under the ACA


Some observers have feared that many who signed up for insurance under the Affordable Care Act would be  sicker than those with employer-based health programs and would be especially likely to seek out expensive specialists.

But a Reuters study suggested that these new entrants, while enthusiastic about getting preventive care, were no more likely than others to see the aforementioned pricey specialists. If anything, the study reminds us at Cambridge Management Group that the newly insured  is boosting demand not only for primary-care physicians but also for nurse practitioners and physician’s assistants.

Reuters said that  the profile of people covered by the Affordable Care Act exchanges came from  ZocDoc, a free online appointment-booking tool used by millions of people in all 50 U.S. states.

”The data, covering thousands of users aged 18 to 64, suggests that ‘the vast majority who signed up in the first wave of Obamacare didn’t have acute medical needs, contrary to expectations,” Dr. Oliver Kharraz, ZocDoc’s co-founder and chief operating officer, told Reuters. ‘The biggest news here is the absence of dramatic utilization differences.”‘


Still, a caveat: ”The question is whether, over time, preventive care visits lead to more use of specialists,” Elizabeth Carpenter, director of the healthcare-reform practice at Avalere Health, told Reuters. “Obviously, the more individuals seek preventive care and screenings the more likely they are to be referred to a specialist.”






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