Changes in primary care access at community health centers between 2012/2013 and 2016

Abstract

Objective: To compare access at community health centers (CHCs) vs private offices (non-CHCs) under the Affordable Care Act. Data Source: Ten state primary care audit conducted in 2012/2013 and 2016. Study Design: CHCs and non-CHCs were called. We calculated difference in differences comparing CHCs vs non-CHCs by caller insurance type. Principal Findings: In both rounds, Medicaid and uninsured callers had higher appointment rates at CHC than non-CHCs. CHC appointment rates significantly increased between 2012/2013 and 2016 for both employer-sponsored and Medicaid callers, with no significant wait time changes. Appointment rates increased (13.5% points, P < 0.001) and wait times decreased (−5.7 days, P = 0.017) at CHCs relative to non-CHCs for employer-sponsored insurance. Conclusion: Appointment availability at CHCs improved after ACA implementation, without increased wait times.