How are Health Care Changes Influencing the Way Medical Practices Get Paid?

by Applied Medical Systems

The Affordable Care Act or the ACA has significantly influenced the way medical practices get paid. It represents the largest insurance coverage expansion in the United States healthcare system since 1965, the year Medicare and Medicaid were enacted. However, there are new health care changes on the horizon. The ACA is now being threatened with a new plan, coined “Trumpcare”. If Trumpcare is approved, it will once again shift the way medical practices get paid. While it is still in effect, let’s dive deeper into several of the many ways the health care changes brought about by the ACA have likely affected your income and the overall success of your medical practice.
  1. More Services Are Covered

Thanks to the ACA, some services that were not previously covered by your patients’ insurance companies are now covered. This means that insurers are now forced to pay medical providers like yourself for essential health services like maternity care, chronic disease management, rehabilitation services, and mental health services.
  1. More Patients Have Insurance Coverage

Since millions of Americans now have insurance coverage for the first time ever, they are searching for a primary care physician as well as specialists. These Americans are part of the low-income population and have received subsidies to pay for their for insurance coverage as well as any out-of-pocket expenses.
  1. Large Focus on Primary Care

The ACA has placed a large focus on primary care physicians. Primary care physicians are now the first line of service for physical, mental, and behavioral needs. Due to this great emphasis on primary care, if you are a primary care physician, you are now billing for more services.
  1. Higher Out-of-Pocket Payments

Since the ACA has sparked higher out-of-pocket payments for patients, you will have to make sure that your practice is collecting these payments up front. If a patient is unable to provide you with an out-of-pocket payment during the time of service, you may have to ask them for their credit card information and set up a budgeting plan.
  1. Physician Ratings and Reviews Are More Important

The healthcare changes that the ACA has implemented have made patients more selective when choosing physicians. Patients often visit Physician Compare, a website that was designed by the Centers for Medicare & Medicaid Services to search for a physician and compare them to others in their area. That being said, physician ratings and reviews are more important than ever before, making it essential for you to maintain high ratings if you don’t want to lose any patients.
  1. Increased Penalties Reduce Reimbursements

There are a wide variety of regulations imposed by the Centers for Medicare & Medicaid Services. Medical practices that fail to comply with these regulations face penalties which can substantially hinder their reimbursements. Therefore, you must make it a top priority to adhere to all regulations.

Ready to Learn More About Health Care Changes? Contact Applied Medical Services Today

With changes to the ACA underway, your practice needs to be prepared. We’ll be happy to provide you with more details while educating you on how our services can improve the profitability and productivity of your organization. Contact us today!