5 Thing Primary Care Providers Need to Know About the ACA

The Affordable Care Act is coming, and physicians will need to get ready for significant changes to the healthcare landscape.  Here is a list of the top 5 big changes that primary care providers will see in relation to the Affordable Care Act.

What You Need To Know About The ACA

1. Increased Coverage for Patient Care

With the kick off of the Affordable Care Act, American could see a record number of individuals with healthcare coverage.  Estimates are close to 32 million anticipated individuals who will now have either Medicaid, Medicare, Medicaid/Medicare (dual eligible), or the opportunity to purchase insurance through the newly formulated Health Insurance Exchange Marketplaces which will open Oct. 1st 2013.  Additionally, those with complex or costly conditions will no longer be denied coverage, and new equitable coverage will provide for the treatment of mental health, behavioral health, and substance abuse conditions.  This means that for many primary care physicians practices will increase the number of patients treated.  Thanks to another provision the amount provided for this care will also increase for primary care providers.

2. Primary Care Provider  Incentives

Physicians who practice in a primary care facility, or in some areas which are rural, or under-served will see a 10% increase in Medicare reimbursement.  The new reimbursement rates will bring Medicaid payments on par with Medicare payments for 2013 and 2014.  Additionally, for those in areas experiencing a physician shortage with 60% of their billing occurring in the primary care setting there will be a 10% Medicare bonus.  This bonus went into effect in 2011 and will continue through 2015.

3. Emphasis On Prevention

Prevailing thought is that it is more cost effective to prevent a disease than to treat one, and there will be a significant emphasis placed on preventative care.  Many basic services and health care screenings will become available to individuals at no charge, and with no deductible or co-pay.  This includes wellness visits for seniors and children, physicals for adults, and other basic screenings such as colonoscopies and mammograms.  The preventative push is aimed at reducing overall spending by prevention or disease or early treatment.  Additional grants and funding will also be available for innovative wellness programs, and further funding may be provided to providers who serve specific populations in which common preventable health conditions (like obesity and diabetes) are prevalent.

4. Care Collaboration Will Increase

With many of the new data and IT requirements, most notably the push for Electronic Health Records (EHRs) physicians can expect to see a streamlined healthcare process with less administrative time spent on administrative tasks and records upkeep.  Improved care will be an off-set benefit of this as providers will be able to work collaboratively to treat a patient with access to a holistic treatment record through EHR information sharing.  Insurance forms and claims may also be simplified with new electronic processes which aim at improving efficiency.

5. The Physician Shortage Will Be Addressed

One of the most troubling events in healthcare today is the shortage of physicians.  According to data and trend reports this shortage is anticipated to worsen in the upcoming years.  The Affordable Care Acts emphasis on access to care could cause the physician shortage to be a barrier to implementation.  Despite coverage, in some areas there are simply not enough specialists or providers to offer adequate treatment to the population in their area.  Part of the ACA will be provisions directed at addressing this shortage.  New incentives are being put into place to provide financial bonuses to primary care providers who are practicing in a rural or under-served area, while long term strategies offer incentives, financial aid, and grants to those looking toward entering the field of healthcare in an effort to boost the number of new physicians entering the field.

Get Ready for the Changes With a Free ACA Webinar. Do you want to know more about the ACA?

It is important that every healthcare organization has a thorough understanding of the Affordable Care Act, and how it has the potential to impact them and their organization.  Change will be swift and the reform will be sweeping, requiring a number of clinical, administrative, and financial changes in order to operate successfully and profitably.  If you would like more information about how to prepare your organization for the ACA Impact, BHM will be hosting a free no obligation webinar entitled The ACA Impact on Hospitals, we hope that you will join us.

Title: What Do You Know About The ACA?

Impact of the ACA on U.S. Hospitals

Description: Find out what your organization can do to brace for the Affordable Care Act (ACA) and what strategies you can implement now to succeed in a changing environment. What do you know about the ACA?

Date & Time: Thu, Oct 3rd, 2013 at 12:00 pm EDT

Please register for the above meeting by visiting this link:http://BHMHealthcareSolutions.enterthemeeting.com/m/TWWX6JZM

Once you have registered, we will send you the information you need to join the webinar.