The Affordable Care Act (ACA) has increased the share of the population with health insurance. Most of the newly insured are young and reasonably healthy. As a result, the ACA will primarily affect the demand for primary care services, and many anticipate a shortage of primary care physicians (Porter 2015).

But some other observers suggest that this concern is overblown (Auerbach et al. 2013). The production of primary care is changing in ways that shift its supply. One change is the rapid expansion of patient-centered medical homes, which emphasize a greater role for technology, nurses, physician assistants, and nurse practitioners. Another change is the growth of nurse-managed clinics (of which MinuteClinic is an example). Both of these innovations reduce the number of physicians needed to provide primary care for a population.

• If there were a shortage of primary care physicians, what would happen to their incomes?
• Do the changes in the incomes of primary care physicians suggest there is a shortage?
• If retail clinics and patient-centered medical homes continue to expand, how will they affect the market equilibrium? Which curve would shift as a result: demand or supply?
• Patient-centered medical homes typically expand the roles of registered nurses. How would this affect the demand for primary care physicians?
• The ACA increased some payments for primary care. How would this affect the demand for primary care physicians?

Note. Case 10.2. How large will the shortage of primary care physicians be? Adapted from Economics for Healthcare Managers, by R. Lee, 2019, Health Administration Press, p. 265-266.