How the Affordable Care Act Will Benefit Your Practice

As we wait for the Supreme Court to hand down its decisions on the Patient Protection and Affordable Care Act (ACA), I for one am hoping for an outcome that upholds the tenets of the law. Why? Because it’ll be good for doctors.

As patient-centered as the legislation may be, its elements impact the entire healthcare system: providers, consumers and insurers. The industry has already begun adapting to the provisions of the ACA, and as it continues to (so long as the court rules in its favor), the results will prove positive across the board – including at your practice.

Gain More Patients
The so-called “individual mandate,” which requires that most individuals obtain health insurance or otherwise face penalties, is the hot-button issue of the ACA debate.

The individual mandate will be the “trigger” factor that affects all of the results we see from the Supreme Court this month: whether the justices make a ruling or delay the decision; whether the mandate is found constitutional; and whether the insurance requirement can be ruled upon separately from the rest of the Act or is un-severable from the ACA law in its entirety.

If the court’s decision proves favorable to the individual mandate, you’ll serve to benefit as a physician. When more patients have health insurance (because they’re required to or otherwise), they’re more likely to seek medical care from you and your colleagues.

Recent research from the Commonwealth Fund showed that among uninsured adults, 60% have failed to get medical care because it’s too expensive. The trick to getting those people to the doctor’s office, for the benefit of their health and the doctor’s bottom line? Getting them insured, as the ACA seeks to do.

If you’re looking to expand your practice, your business will benefit from a widely covered patient population that can better afford care.

Serve a Healthier Population
Similarly, once patients are insured – and secure that they’ll stay that way – they’re more likely to engage in the healthcare system to ensure their ongoing wellness.

Certain elements of the Affordable Care Act are enabling more individuals to gain covered access to needed services and make healthcare a fixed part of their lives.

2.5 million new young adults have gained access to insurance thanks to the ACA provision that allows them to stay on their parents’ plans until age 26. Those patients, who participate in their healthcare in early adulthood, will be more likely to form long-term relationships with their providers and continue to receive care throughout their adult lives.

Additionally, the ACA requirement that insurers cover pre-existing conditions has allowed many individuals to keep the health plans they otherwise would have lost or been denied from the get-go. In all, 34 million Americans are insured who weren’t before the ACA was signed.

The more widespread coverage is allowing more people to take better care of themselves by seeking valuable primary care services and incurring few costs in the process. In 2011, more than 85 million Americans received preventive healthcare services without paying co-pays, deductibles or any other out-of-pocket expenses.

If you’re a primary care provider rendering preventive services like wellness visits and check-ups at no charge to your covered patients, you’re helping create a healthier patient base for your practice – which will bode well for your business under the quality measures it will be judged on down the line under the ACA.

Sustain Your Business (and Your Industry) Long-Term
The ACA is not without its flaws, but its provisions control healthcare costs in ways that will not be feasible if the law is rejected in its entirety.

If the individual mandate alone is even struck down by the Supreme Court, studies estimate that individual health insurance rates will increase 12-25 percent, since fewer healthy individuals will be obtaining coverage than with the mandate.

Plus that immediate increase in rates would be just a fraction of the overall costs that would continually increase.

At present assessments, the average cost of a year of medical care has risen 113 percent since 2001. The skyrocketing costs may have benefited specialist physicians’ wallets, but they’re not sustainable. If trends continue in that direction in coming years, healthcare will be virtually unaffordable a decade from now.

How many of your patients could afford to see you if the costs they pay for treatment and procedures are doubled and their monthly rates grow 12-25 percent higher? How well would your practice fare in that type of financial environment?

These are difficult questions to answer, but they’re the ones doctors should be considering as they await the Supreme Court’s ruling. Keep in mind: a decision in support of the ACA could result in long-term successes – for the health of your practice, and of your patients.

What about a ruling against the ACA, you ask? Check back tomorrow for a look at the other side of the Affordable Care Act – the negatives it could incur on your medical practice if upheld.

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