What is the Impact of ObamaCare on Physician Reimbursement?

Healthcare in the United States is still being developed around private insurers and public providers. ObamaCare was signed into law to make affordable healthcare services accessible to patients all over the country. ObamaCare required insurance companies, hospitals, clinics, and private practices to make many changes to accommodate patients without prejudice. Some of these changes have affected how physicians and private practices are reimbursed by insurance companies covering a patient under ObamaCare. This article discusses the impact of ObamaCare on physician reimbursement.

impact of obamacare on physician reimbursement

ObamaCare

ObamaCare, or the Affordable Care Act, has made health insurance a requirement for all Americans. ObamaCare was signed into law on March 23, 2010. Under the terms of ObamaCare, insurance providers cannot deny coverage to patients with pre-existing conditions. ObamaCare also regulates the prices of healthcare plans in accordance with a market of free commerce, so that all patients are eligible for affordable healthcare coverage. Although the free market principle has resulted in low cost insurance, it has also resulted in lower coverage.

Physician Reimbursement

Many physicians and private practices have noticed a decrease in reimbursement from ObamaCare plans. As these plans are provided by private insurers, many doctors felt that their businesses would still receive the same kind of operating revenue as they had been.

According to an article from the New American, one doctor has noticed a substantial decrease in reimbursement.

‘I cannot accept a plan [in which] potentially commercial-type reimbursement rates were now going to be reimbursed at Medicare rates,’ Dr. [Doug] Gerard told NPR. ‘You have to maintain a certain mix in private practice between the low reimbursers and the high reimbursers to be able to keep the lights on.’

Dr. Gerard is describing how his practice is his business, and that his operating expenses are becoming prohibitive due to reduced payments from ObamaCare health plans.

ObamaCare has resulted in:

  • Reduced reimbursement rates from private insurers of $100 down to $80.
  • Reduced health care availability to consumers because physicians are changing their businesses to a cash only model.
  • Reduced quality of care for consumers as insurers adjust their health plans to match the costs of ObamaCare plans.

Many primary care physicians have felt that ObamaCare is stifling their business, so they are choosing early retirement. The problem is compounded by fewer medical students pursuing careers as a physician.

ObamaCare was provided as a means for Americans to receive healthcare at affordable rates. This required insurance companies to adjust their plans in order to accept lower rates. Many physicians have found that ObamaCare plans reimburse their practices at levels similar to Medicare and lower than private insurance. This has resulted in several unintended side effects within the American healthcare system, that manifest themselves as a reduction in healthcare quality.

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