The Affordable Care Act (ACA) is having a profound effect in the business of health care. While the ripple effects of the law are widespread, there are a few key elements those in the business of health care must understand. Our first tip is related to the effect of the ACA on compensation.
- The ACA is shifting compensation structures for health services.
- The ACA mandates coverage of a number of additional services not previously covered in many health plans, including dozens of preventative services. New converge means additional reimbursements from insurers for these services, which previously may have been skipped or refused by doctors and patients.
- An additional big impact of physician and practice compensation comes from the expansion of Medicaid benefits. Health care providers in states that have adopted the Medicaid expansion can expect to see new business, and a decreased need to see lower-income patients on a discounted or free basis.
On the other hand, the ACE likely means higher out-of-pocket payments for some services, requiring the need to set up new payment plans and other means of ensuring compensation.