As the American political machine grinds out its latest iteration of potential healthcare reform, changes in the system as it stands will impact far more than the projected millions of people that could lose insurance coverage. Healthcare systems, namely hospitals, as well as private physicians’ offices will see major shifts in the way their patients are able to access them and pay for the services they receive. Business planning for a medical practice or annual budgeting for a healthcare system are going to be moving targets, as conditions will likely continue to change as the political climate shifts. The Affordable Care Act (ACA) is the subject of all the debate, and has seen bills proposed that could potentially replace it with a new law or simply repeal it.
While the ACA has had its issues, one major effect has been a swell in the overall numbers of insured people in the United States. This means that people who might have waited until a health concern became a true emergency before visiting a doctor began visiting primary care practices to engage in preventative healthcare. This generated more patients for family practices and other offices, especially in areas with more poverty and higher unemployment. Many practices were absorbed or purchased by larger healthcare systems and many more made significant adjustments to their operations to adapt to the new reality.
As the situation evolves now, the opposite may begin to be seen, where many of the patients that gained access to insurance start to drop off plans that become either too expensive or nonexistent altogether. With an estimated 17 million people projected to lose insurance (voluntarily or not) under certain versions of new legislation, these people will return to the pool of uninsured and may not be able to continue regular visits to primary care, which means that the investments and changes made to these practices will not be sustainable.
One part of the ACA that was almost universally opposed was the introduction of several new regulations, requiring increased record-keeping and other administrative tasks. Many doctors and providers have argued that their time has been taken away from serving their patients and has instead been spent doing paperwork or answering emails and filling out forms. While the reality is likely somewhere between the two situations, the regulatory climate under a new healthcare law will likely see more changes.
Differences in politics aside, one thing has become very clear in the preceding six months: healthcare reform is extremely challenging and highly polarizing. Acknowledgment of this may lead to a third, and perhaps more viable, option: keeping the ACA, but updating it in parts. This will require a heightened awareness of the changing regulations, as some may be removed, some may stay in place, and some may develop into different regulations completely.
Regardless of how far the nation’s healthcare laws end up from where they are today, nearly every person in the country will be affected in one way or another. Where your practice falls on the impact spectrum will largely depend on your geographic location and the types of clients you currently serve, but even those that see minimal differences in their overall client base will be faced with evolving regulatory and financial impact. Responsive practices will keep abreast of the changes, preparing to weather the reform’s effects on patient numbers, administrative regulations, and the financial liabilities that result from all of the chaos.