The Top Five Things You Need to Know About the Affordable Care Act

Written by on April 30, 2013 in Insight - No comments

DoctorsWEBThe Affordable Care Act (ACA) was signed into law in March 2010. You may have concerns about how ACA will affect you and your practice – your reimbursement, your independence, and the welfare of your patients.

You should know that ACA has the potential to bring considerable financial and clinical benefits for providers across the health care spectrum. The law enacts comprehensive reforms that will hold health insurance companies accountable, protect you and your patients, and guarantee choice and control.

Here are 5 specific ways you and your practice can benefit:

1. New consumer protections hold health insurers accountable. Insurers won’t be able to cancel coverage when a patient gets sick, and they won’t be able to set lifetime benefit limits that leave patients without coverage in times of catastrophic need. And if insurers don’t spend at least 80% of premium dollars on patient care, they’ll have to provide a rebate to consumers. These protections will end the worst insurance company abuses and put patients and providers ahead of company profits.

2. Expanded insurance coverage to more than 34 million people. In 2014, the law eliminates exclusions based on pre-existing conditions, and makes affordable health coverage accessible to more than 34 million uninsured Americans. This will reduce the burden of uncompensated care on physicians and hospitals and bring more patients into your practice. Right now, the law already makes it possible for young adults to remain on their parents’ coverage till age 26, and the Pre-Existing Condition Insurance Plan provides coverage for people who’ve been rejected by insurance companies.

3. Reduced administrative burdens and more time seeing patients. The law invests in programs designed to help you and your practice transition to electronic record systems. We’re working with your professional organizations to support your efforts to adopt new payment and record-keeping systems, with the goal of reducing your administrative burdens. New rules are intended to help simplify claims and payment processes — we want you to be able to spend more time in the exam room, and less on administration.

4. New models create more opportunities to coordinate care. We’re working to develop new models of patient-centered, efficient, coordinated care designed to give you more support and control over the care you give: faster information flow across care sites, better consults, and provider support systems that help patients become active participants in their care. And Medicare will pay bonuses to qualified primary care doctors. Bonuses are available to general surgeons as well, particularly those who practice in underserved areas.

5. New protections strengthen patient coverage, your practice, and the entire health care system. The Affordable Care Act preserves guaranteed benefits under Medicare; makes recommended preventive services available for free; and provides patients with an annual wellness visit. The law also requires insurers to cover an expanded list of preventive services for free, including a number of services for children. Patients will be able to afford both routine preventive care and necessary treatments. You got into the health care profession to serve patients — ACA protections are designed to help you keep serving them.

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