It’s a time of high anxiety as the Affordable Care Act gets ready to put its signature expansion in place. Starting October 1st, health insurance exchanges will go live in all states allowing all uninsured citizens above the federal poverty level the ability to purchase affordable health insurance. In 25 states Medicaid expansion will be taking place allowing those making less than 138% of the federal poverty level to get Medicaid.
The logistics are daunting. Doctors will tell you that they don’t know how all this will play out or what it means for their practices in the coming year. But dig deeper and you’ll find that most of us support the goals of the ACA. Getting 30 million people access to quality affordable health care in the coming years is a worthy goal. But there are other benefits for doctors in the ACA:
- Medicaid payments to primary care doctors have increased to the same level as Medicare payments. This change has been long overdue and recognizes that cost savings shouldn’t come at the expense of physicians who do the same work for a patient regardless of who is paying.
- Primary care doctors seeing Medicare patients are receiving bonus payments. This too is a recognition of the value of primary care and serves as an incentive for doctors to maintain or expand access to Medicare patients.
- There are expanded opportunities for sharing in cost savings. Everybody agrees that costs in our health system are out of control. But that’s where the agreement ends since everyone also seems to have their own idea of how to bring costs down. The ACA authorizes demonstration projects which will give physicians an opportunity to test their ideas for decreasing costs while improving the quality of care. Those that are successful will be able to get a portion of the money saved by Medicare.
- Tort reform projects are being funded in states to explore new models for handling medical malpractice . This is an issue that weighs heavily on the minds of doctors and there has been much discussion about how the system should be reformed to be both fairer to doctors and patients who have truly suffered from malpractice. This will be an opportunity for states to be responsive to their doctors in experimenting with new models of handling medical malpractice claims.
These are just a few of the ways the ACA directly support doctors and addresses some of their concerns as we enter a new health care landscape. For these and many other reasons doctors are among the leaders stepping up to implement the needed and sweeping changes that are on the horizon.