Providers see boost in patients thanks to ACA

WELL OFF: Nurse practitioner Cathleen Jaderquist-Bassett, left, with patient Lorraine Robitaille at WellOne Primary Medical and Dental Care in Foster. Bassett said the Affordable Care Act is bringing in more insured patients. / PBN PHOTO/ MICHAEL SALERNO
WELL OFF: Nurse practitioner Cathleen Jaderquist-Bassett, left, with patient Lorraine Robitaille at WellOne Primary Medical and Dental Care in Foster. Bassett said the Affordable Care Act is bringing in more insured patients. / PBN PHOTO/ MICHAEL SALERNO

One man who is in his 30s came into the Foster office of WellOne Primary Medical and Dental Center when he finally got health insurance as a result of the Affordable Care Act.
“I sent him to the hospital. He has leukemia. He was working and didn’t treat it,” said nurse practitioner Cathleen Jaderquist-Bassett. “They did lab work and the hospital admitted him.”
That man is an extreme case of medical problems gone untreated because someone didn’t have health insurance, said Jaderquist-Bassett, but is part of a trend she has seen since the implementation of the Affordable Care Act.
“I don’t have numbers, but I can tell you I’m seeing more patients, men and women, coming in more routinely for a variety of conditions, like hypertension or asthma,” said Jaderquist-Bassett.
“I’m seeing more patients who have diabetes come in more regularly,” said Jaderquist-Bassett. “Without health insurance, some of the patients with diabetes couldn’t afford their medicine. Then their diabetes would get out of control and they developed kidney problems.”
The increase in patients at WellOne is reflective of the nationwide trend that’s come along with the Affordable Care Act, said MaryAnne Sapio, vice president of federal government affairs for the American Association of Nurse Practitioners.
“Frankly, it’s something we anticipated and we’re seeing it now,” said Sapio. “We’ve had people insured for several months now and we’re starting to see them accessing care.”
According to a June 27 video report by Gallup Editor-in-Chief Frank Newport, 5 percent of adult Americans are newly insured as of 2014, meaning they didn’t have health insurance before, but now they do. That Gallup poll was done between April 15 and June 17.
Some women who previously didn’t have health insurance used to come into the WellOne medical center for an annual cancer screening, which is available at no cost to eligible Rhode Island residents through the Women’s Cancer Screening Program, according to the R.I. Department of Health. During that visit, Jaderquist-Bassett would do an annual physical or address their other medical issues.
“They’d try to cram everything into that one visit,” said Jaderquist-Bassett.
With more people having access to affordable insurance, Jaderquist-Bassett said each condition, perhaps asthma or COPD, which is chronic obstructive pulmonary disease, gets more regular attention.
The Affordable Care Act is still the cause of intense national controversy, including concerns about costs and complexities for businesses.
As of May 31, HealthSource RI, the state’s health-benefits exchange, had 27,107 people enrolled in medical insurance programs, said exchange spokeswoman Dara Chadwick.
For medical organizations such as WellOne, which offers medical, dental and behavioral health care at its three locations in Foster, Burrillville and North Kingstown, the numbers are not yet tallied, but the trend is taking shape, said Well-One Vice President and Chief Medical Officer Andrea Marcotte.
“We are seeing an increased demand for services,” said Marcotte. “Some of our existing patients didn’t have insurance and now they do. With those who had insurance, there’s a bigger push for preventative care. There are many insurance incentives to get yearly physicals and obtain screenings.”
WellOne is a federally qualified health center and receives some funding through the Health Resources Service Administration, said Marcotte.
“We see all patients regardless of ability to pay,” said Marcotte. “We have patients who are insured, uninsured and underinsured.
“We’re seeing a lot of outreach by insurance companies – more communication with primary care providers,” said Marcotte. “Patients who may not have frequented a primary care office are getting a push from their insurance companies to have a primary care visit and have screenings, like a mammogram, a colonoscopy or a skin examination for melanoma. “Overall, there’s an increased awareness that primary care is so important. Instead of focusing on illness, we’re focusing more on primary care and wellness,” she said. “There’s a focus on overall lifestyle and issues such as weight-loss management.”
Along with emphasis on primary care and the increase in patient loads comes the need for more medical staff, said Marcotte.
“We hired one more physician recently and we’re recruiting for one more nurse practitioner,” said Marcotte.
With the increased demand resulting from the Affordable Care Act, “We expect nurse practitioners to be on the front lines for delivering care,” said Sapio.
Rhode Island is one of 19 states and the District of Columbia that are “full-practice authority” states, she said.
“That means that nurse practitioners can practice to the full scope of their education and preparation,” said Sapio.
The ability of Rhode Island’s nurse practitioners to provide extensive medical services is a plus with the growing demand, she said.
“Absolutely, being in a state where nurse practitioners have full-practice authority is an advantage for patients,” said Sapio. “It allows more patients to access services. Nurse practitioners can diagnose, treat and help manage chronic disease.”
As the demand for medical services, notably primary care, increases, nurse practitioners will tend to choose to practice in states such as Rhode Island where they can utilize the full depth and breadth of their training, she said. •

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