Prepare Now for the Affordable Care Act (ACA)

The Affordable Care Act (ACA) was upheld by the Supreme Court in June of this year. No mater which way the November election goes ACA is pretty much a done deal. Our colleagues at Software Advice have put together a list of 5 ways physicians can best prepare for the impact of ACA:

1. Make Preparations for More Patients
For three reasons, the Affordable Care Act (ACA) will increase the number of patients many physicians see. First, an additional 32 million American will receive coverage under the Act. Second, insurance companies will be required to extend coverage for more preventive care procedures. Third, insurance companies will no longer be able to deny coverage for pre-existing conditions. Practice may wish to expand its staff of increase hours to accommodate more patients.

2. Decide Now About Medicare and Medicaid
Medicaid payments are slowly catching up to the Medicare rates, but they still only represent 81% of the reimbursements of private insurance. Qualification changes may also lead to patients switching over to Medicaid from private insurance companies. Physicians should decide whether they will continue to accept Medicare/Medicaid payments, as the costs will continue to increase.

3. Adopt EHRs Soon if You Want Government Incentives
Reporting requirements and reimbursements are expanded under the ACA, and physicians will see penalties for Medicare reimbursements starting in 2015 without adopting Electronic Health Records (EHRs). This will encourage some doctors to purchase an EHR, while others chose not to and to drop government payers from their practices.

4. Consider Moving Your Practice to a Rural Location
The ACA provides loan reimbursement and scholarship incentives to physicians that practice in what it deems “underserved areas.” This may be alluring to young doctors or doctors looking to move and start a new practice, and something to investigate if your practice is not already established.

5. Consult Accountable Care Organization Options
Finally, the ACA creates Accountable Care Organizations, or ACOs. These are physicians that jointly coordinate care for patients, leading to the theoretical reduction of the cost of care. The government passes on half of the savings seen in these ACOs directly to the providers as a bonus for their cooperation.

Research for this piece was provided by David Fried and Software Advice.