Scheduling primary care appointments online: Differences in availability based on health insurance

Area of Science:

• Digital health platforms
• Healthcare access research
• Health services research

Background:

• Online and smartphone applications for scheduling physician appointments are increasingly common.
• The accessibility and equity of these digital health platforms have not been thoroughly evaluated.

Purpose of the Study:

• To assess the availability and proximity of primary care physician appointments booked through ZocDoc.
• To compare appointment access across different insurance types (self-pay, Medicare, Medicaid) and states with varying Medicaid expansion policies.

Main Methods:

• Systematic searches for primary care physician appointments were conducted in 20 cities using ZocDoc.
• Appointment availability was analyzed for self-pay, Medicare, and Medicaid insurance.
• Data collected included physician characteristics, appointment numbers, and distances to clinics in states with and without Medicaid expansion.

Main Results:

• The study analyzed 4150 physician observations across 17 states.
• While overall appointment access was substantial, Medicaid patients faced greater challenges.
• Medicaid appointments were located further away (5.4 miles more) with fewer physicians available within 5 miles compared to self-pay patients.

Conclusions:

• Digital platforms provide a significant number of accessible appointments.
• However, disparities exist, with Medicaid patients experiencing reduced access to nearby primary care physicians compared to self-pay and Medicare patients.