Healthcare reform, otherwise known as Obamacare, has generated mostly negative attention from most of the broadcast, print and digital media. There are some good reasons for this less than complimentary attention.
- Many healthcare marketplace websites have had serious bugs, preventing people from purchasing mandatory health insurance.
- Many health insurance products are too expensive for a large number of Americans, particularly the middle class, which is getting financially squeezed by the current economy.
- The citizenry remains generally unhappy with and/or confused about many provisions in the Affordable Care Act (ACA).
- High deductible health plans shift too many payment burdens to patients.
These negative opinions and facts typically hide the potential benefits offered by Obamacare—particularly for medical providers. Physicians often hope that Obamacare succeeds, because it’s here whether we want it or not.
Yet, media reports have ignored the possible benefits physicians may receive. Even many medical industry publications and associations largely have ignored the possible ‘silver lining’ that comes with Obamacare.
Less Publicized Benefits
Despite all the negativism, consider the less publicized benefits of Obamacare. While there are numerous less important benefits, the following should qualify as the silver lining of healthcare reform for physicians.
- Obamacare supplies the top component for increasing physician revenue: More patients. Particularly significant to independent providers with smaller practices, more patients provide the opportunity for physician to grow their practices.
- The original healthcare reform debates often centered on reducing Medicare reimbursements because of unsustainable payment levels. To date, even with the implementation of the ACA, Congress has kept Medicare reimbursement amounts at former levels.
- The shifting focus from care quantity to quality of care should motivate physicians to offer and patients to receive high quality care. Providers committed to earning the incentives that come with delivering quality care will enjoy increased income. Although targeted to doctors offering Medicare services, pay-for-performance (P4P) incentives are attracting many major private healthcare payers, who are participating in this initiative.
- In states agreeing to expand their Medicaid programs, physicians will be reimbursed equally for Medicare AND Medicaid diagnostic and treatment services. Historically, Medicaid reimbursements were significantly lower than Medicare payments. The ACA specifies that Medicaid payments should have parity with Medicare reimbursements for identical treatment and procedures.
- Incentives to practice in ‘underserved’ areas. The ACA provides bonuses (10 percent) to primary care physicians (PCPs) who open a practice or continue to offer service in ‘medically underserved communities.’ This bonus mirrors the Medicare provision providing incentives for practicing in underserved areas.
- Insurance must offer coverage for pre-existing conditions. This provision also providers to grow their practices by encouraging patients to seek treatment for pre-existing conditions, often excluded from many health insurance plans before Obamacare. Since the private foundation promoting improved healthcare for Americans, The Commonwealth Fund, in a 2010 research study, found that around 60 percent of people lacking health insurance did not request medical care fearing the cost. The ability to have coverage for pre-existing conditions will have more patients seeking treatment.
These are but some components of the little publicized physician—and patient—benefits of Obamacare. Instead of focusing on the negatives of healthcare reform, physicians should evaluate the benefits and take appropriate action to maintain or increase practice income by growing their practices and qualifying for incentives offered when delivering high quality care.
Providers that use P4P as a positive motivator can eliminate most of the negative perceptions surrounding Obamacare. Instead, forward-thinking and creative providers will enjoy the often disguised positive advantages for physicians offered by the ACA. Doctors are encouraged to reap the rewards, not endure perceived penalties.