On March 18, the Robert Wood Johnson Foundation (RWJF) published a study examining the impact of the current supply of primary care physicians (PCPs) on the national health care reform law’s Medicaid expansion.  The authors estimate the law will result in 16 million new Medicaid beneficiaries by 2019, with a disproportionate increase in the South and Mountain West regions.  Because those regions already have the lowest concentration of PCPs, the authors caution that the expansion will disproportionately impact demand for PCP services in those areas.  The brief suggests that states implement delivery system reform and improve access to primary care services to ensure that the Medicaid expansion provides adequate and accessible health services to all newly eligible residents.

From the report: 

Under the Patient Protection and Affordable Care Act (PPACA), Medicaid enrollment is expected to grow by 16 million people by 2019, an increase of more than 25 percent. Given the unwillingness of many primary care physicians (PCPs) to treat new Medicaid patients, policy makers and others are concerned about adequate primary care capacity to meet the increased demand. States with the smallest number of PCPs per capita overall—generally in the South and Mountain West—potentially will see the largest percentage increases in Medicaid enrollment, according to a new national study by the Center for Studying Health System Change (HSC). In contrast, states with the largest number of PCPs per capita—primarily in the Northeast—will see more modest increases in Medicaid enrollment. Moreover, geographic differences in PCP acceptance of new Medicaid patients reflect differences in overall PCP supply, not geographic differences in PCPs’ willingness to treat Medicaid patients.

Full report: State Variation in Primary Care Physician Supply: Implications for Health Reform Medicaid Expansions (PDF | 873.63 KB)

Robert Wood Johnson Foundation.  (2011).  State variation in primary care physician supply: implicatins for health reform Medicaid expansions.  Cunningham, P.