Affordable Care Act: 5 Steps to Prepare Your Practice

With only a few days until the 2012 U.S. Presidential Election, the future of Affordable Care Act (ACA) is a hot topic. If Obama is re-elected, the ACA is undoubtedly here to stay. However, is Romney is elected, Obamacare is likely to be maintained, as well. Here’s why:

Romney would likely lack a majority in the Senate to overturn the ACA, as even after the election, the Senate is predicted to 51-47 split between Democrats and Republicans. Even in 2014, the Democrats would likely maintain a majority, as the President’s party has lost seats in the Senate in 21 of the last 26 midterm elections.

Could an executive order overturn the ACA? In truth, no. The President lacks the legal grounds to undo an Act of Congress, and the state waivers that the President could grant are very limiting–and unable to go into effect until January 1, 2017, close to the end of the next President’s term.

Therefore, it’s a safe bet to prepare for the implications of Obamacare, regardless of the outcome of the Election.

What can you do safely prepare for the ACA’s impact?

First, you should prepare your office for more patients. The ACA will increase coverage to 32 million more Americans, require insurance companies to cover more preventive procedures than in the past, and prohibit providers from denying coverage for pre-existing conditions. This will result in frustrated patients waiting in your lobby if you don’t prepare accordingly. Consider hiring more administrative staff or extending the hours of your practice to better accommodate patients.

Second, you should decide how to treat Medicare and Medicaid patients. As changes in qualification will result in individuals transitioning from private insurance providers to Medicaid, doctors will have to find new ways to offset the additional costs of treating these patients. It is a good idea now to consider how you will address this now before it happens, rather than being caught off-guard later.

Third, it will be important to decide whether you will adopt Electronic Health Records (EHRs) now or ever. Obamacare will effectively increase reporting requirements and reimbursements for physicians, meaning Medicare reimbursements will be negatively affected if physicians lack an EHR by 2015. If practices would like to continue seeing these patients and currently don’t have an EHR in house, they should quickly evaluate their options and start thinking about how to successfully implement a solution.

Fourth, physicians should consider the impact of rural relocation. While this may only be an option to new or younger physicians, the ACA does provide loan repayments and scholarship funds to physicians that maintain their practice in an established, “underserved area.” If you are a physician that isn’t tied down or have considered a move, this may be a great option.

Finally, you can decide to form an Accountable Care Organization (ACO). If physicians coordinate patient care and take on joint accountability, the ACA will pass half of any savings on to the providers. Those interested in ACOs should consider the positives and negatives, as pilot projects have shown that not all ACOs result in improved care (or savings).


Research for this piece was conducted by David Fried of Software Advice. Previous to his work at Software Advice, Fried spent three years as a research specialist for a medical technology consulting company. You can reach him on LinkedIn for more information.

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