Originally, the ACA was projected to result in up to 30 million people gaining health insurance in 2014 alone. However, anyone who hasn't been living under a rock knows that the process of guiding these new individuals into the system hasn't gone exactly according to plan.
That said, a recent report shows that more than 5 million newly-insured have been added to the system so far, and according to the latest projection from the Congressional Budget Office, by 2017 about 25 million people will gain insurance through the exchanges each year.
What's been lost in all the enrollment tracking is that these aren't poll numbers -- these are real patients who will need real access to care in a system that already faces acute challenges in this area.
Consider the rest of the backdrop:
• The U.S. has a primary care physician shortage that is projected to reach a shortfall of 45,000 in the next six years.
• Nearly 20 percent of Americans live in areas with an insufficient number of primary care doctors.
• The prevalence of chronic diseases continues to grow, currently accounting for 70 percent of American deaths each year (with the same percentage of these being preventable).
So again, the question remains: Where are all these people, especially those in medically-underserved and rural populations, supposed to find access to care?
Part of the answer is they are turning to new types of solutions that can supplement (not replace) the care they receive from their PCP or "medical home."
Take local community health screenings. These companies offer affordable tests targeted to the senior population, oftentimes in medically-underserved communities, that help patients identify chronic conditions when preventive steps can still make a difference and improve overall health before it's too late. They focus on the very chronic diseases (stroke, cholesterol, diabetes) that are taking such a toll on our system, and have conducted more than 8 million screenings to date.
Retail clinics are another example. A recent report from Accenture predicts that the number of these clinics (which are largely found in national drug store chains), will double by 2015 with the wave of new patients entering the system. This explosion of clinic growth is also expected to save the health care system $800 million annually by replacing higher cost options.
Although both models have been shown to address significant gaps in care and deliver services that are high quality and safe for patients, like many "upstarts" in an established industry they have met with some skepticism and controversy from traditional established provider groups and organizations.
However, recently retail clinics and community screenings are becoming much more embraced by hospital systems and the physicians that lead them. For example, in the past few years many operators have signed dozens of collaboration agreements with leading names such as Johns Hopkins Medical, and some currently partner with health systems across the country to raise local awareness and to ensure patients without a doctor know where to find one.
The American health care system is facing a crisis of access, and unless thinking outside the box that helps and doesn't harm the patient is allowed (even embraced), patients are simply going to fall through the gaps. This why it's vital that policymakers, insurers, and yes, doctors like myself, take a look at the facts when evaluating these newer services -- and make sure that the realities of the system and the welfare of the patient are being put before everything else.