Is Your Private Practice Prepared for the Affordable Care Act Patient Surge?

An estimated 30 million new patients will be entering the health care system in the next year.  How will practice administrators accommodate the staggering influx of people and logistical changes?

The healthcare industry is facing major changes over the next several years – most notably, the Patient Protection and Affordable Care Act, or PPACA, which takes effect in 2014.

PPACA's key benefits include :

  • free access to preventative and routine care
  • coverage for children with preexisting conditions
  • patients’ ability to seek emergency care in hospitals outside of their network of approved providers

Of course, it’s great news that so many Americans who previously could not afford health care will be able to receive medical assistance, but as PPACA kicks in, the estimated 30 million new patients scenario has left everyone wondering what adjustments will need to be made by health care providers and administrators.

In the realm of private practice specifically, the concerns are:

  • interference in physician autonomy
  • Private physicians have struggled to resolve providing the best care for their patients with interference from non-clinical sources that reduce that autonomy.  These interferences often concern medical billing and defensive medicine pressures, and can often unnerve private doctors to the point that they feel restricted in the decisions they can make to help their patients.  Can this process continue uninterrupted without consequence with so many new people in need of care on the horizon?
  • lack of doctors on hand
  • The trend of individual practitioners working fewer hours is also creating doubt that new patients will receive proper and complete care.  After all, a high volume of new people seeking medical attention will generate a demand for more physicians; one has to wonder if private practices will be short-handed. 
  • the potential monopolization of private practices
  • However, the greatest fear of all has to be the monopolization of private practices, and the financial security of doctors taking precedence over the quality of patient care.  More and more hospital systems and medical groups are forming large numbers of private practices, which some physicians seek out in anticipation of greater financial security. The monetary incentive that makes private practice so alluring, combined with the fact that 52% of private physicians limit or are planning to limit care to Medicare patients, has many people questioning if a physician’s personal interests and the interests of his or her patients are mutually exclusive.  If this is the case, are an increasing number of doctors’ concerns leaning towards the former?

These are some of the factors that hinder attempts to care for so many new people.

It’s not that medical professionals are expected to be completely selfless all the time, it’s just that, when something as intimate as a person’s body is at risk, that person is entitled to their doctor making decisions based entirely on what is best for them medically.  With 30 million more people about to enter the healthcare system, patients hope that ulterior motives or personal concerns won’t influence the care they receive from physicians.

2013 and the coming years are going to bring monumental changes to American healthcare.  Private physicians and their patients alike are worried about solo practices being prepared to assist millions of new patients. Take time now to gain a better understanding of what will be required from you and your colleagues to ensure PPACA is the smashing success everyone hopes it will be.  For support, further discussion, and/or more information on this topic, feel free to contact us.

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