June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Impact of the Affordable Health Care Act on No-Show Rates and Demographics of Patients Presenting for Eye Care in an Underserved Inner City Population – a 2-year Update
Author Affiliations & Notes
  • Joyce khandji
    Ophthalmology, New York University, New York, New York, United States
  • Ann Ostrovsky
    Ophthalmology, New York University, New York, New York, United States
    Ophthalmology, Woodhull Hospital and Medical Center, New York, New York, United States
  • Footnotes
    Commercial Relationships   Joyce khandji, None; Ann Ostrovsky, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5082. doi:
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      Joyce khandji, Ann Ostrovsky; Impact of the Affordable Health Care Act on No-Show Rates and Demographics of Patients Presenting for Eye Care in an Underserved Inner City Population – a 2-year Update. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5082.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the impact of the Affordable Health Care Act (AHCA) two years after its inception on no-show rates and access to eye care services in an underserved inner city population.

Methods : A retrospective cohort study comparing the no-show rates and demographics (age, gender, ethnicity) of patients presenting to an inner city public hospital eye clinic from January 1 through December 30, 2013 (pre-AHCA) with January 1, 2014 through December 30, 2015 (post-AHCA). Demographics were compared by T-test, no-show rates were compared using ANOVA, and payer mix changes were analyzed using the Chi-squared test.

Results : 7582 patients were seen in the pre-AHCA group and 14,981 in the post-AHCA. Age and gender were similar. Fewer Hispanics (51 vs 47%; p<0.001) and more Caucasians (7.8 vs 8.6%; p=0.003) presented post-AHCA. The changes in payer mix for pre- and post-AHCA were all significant except for with Medicaid: HHC options (40 vs 37%; p=0.006), MCP (46 vs 47.6%; p<0.001), Medicare (8 vs 6.8%; p=0.004), Medicaid (4.5 vs 4.4%; p=0.95), self-pay (1.3 vs 2%; p<0.001). The no-show rates for pre- and post-AHCA were 39±8.8% and 45±9% (p=0.05).

Conclusions : Two years after the enactment of the AHCA, more Caucasian patients and fewer Hispanic patients sought eye care. As expected, the proportion of managed care plans presenting to the hospital increased, but the proportion of self-pay patients also increased. Surprisingly, no-show rates have increased post-AHCA, continuing to present a significant challenge to access to care.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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