Us Healthcare Reform

The new healthcare reform act recently passed will be fully implemented by 2014. Every person living legally in the United States will be guaranteed, under the Patient Protection and Affordable Care Act, (PPACA), healthcare insurance. Across the United States, primary care doctors are already preparing for the full impact this will have on their practices.In keeping with the promise made by President Obama, physicians are already planning to increase their hours while trying to maintain patient care.
With this new legislation, there will inevitably be growing pains, for the providers, the patients, and most all for the insurance companies, including Medicare and Medicaid. The Congressional Budget Office (CBO) reports that over 16 million additional adults will be eligible for health care coverage with the new Healthcare Reform Act. That is a substantial increase in patients needing to find a Primary Care Physician ((PCP) ).Shawn Martin, director of government relations for the American Osteopathic Association, says, “We were really pleased with the emphasis put on primary care and the continuous and comprehensive relationship with the primary care provider. ” The reforms will strain the nation’s primary care delivery system, he adds, but “there are ways of dealing with that. ” (Bendix, J. 2010, May) Providers that are considered critics of the new reform bill, PPACA, say that while there may be ways of dealing with the growing demand on the way they deliver healthcare that does not mean that it will be inexpensive.
The growing fear for the average Primary Care Physician is that while the government is busy regulating how they treat their patients: what diagnostic tools they will be entitled to use, which tests they will be allowed to order, and what medications should be prescribed, the compensation that they receive for their services will be cut. Still most providers are currently dealing with this increase is by referring existing patients to specialists that deal solely with their individual diseases: Diabetics will be referred to an Endocrinologist, Cardiac patients will be referred to Cardiologists and so forth and so on.Unfortunately, this system of dealing with the increase is a stopgap and will only prolong the agony; the Primary Care Physician ((PCP) ) will still be responsible for the overall care of their patients and will now have to keep track of the data generated from other healthcare providers. With the influx of new patients on the Primary Care Physician (PCP) , providers are coming up with other ways of handling the added patient load. Some Primary Care Physician (PCP) doctors are extending their hours of operations.Most doctors have implemented a cap within their practices to minimize the number of new patients that can be added to their schedules, thus keeping the impact on their existing patient load to a minimum. Still other (PCP) are preparing their established patients with the new reality that faces them all, patients will no longer have unfettered access to their Primary Care Physician (PCP) .

Additionally, providers are concerned that not only will their patient load increase, but their reimbursements will decrease as well, thus creating an unnecessary burden on the practice as a whole.Hopefully, as more information becomes available, providers can put to rest their concerns. The areas most affected by this legislation are the areas of the country that have a shortfall of Family Physicians, Internists, and General Practitioners. Unfortunately, providers in these areas are going to be impacted the greatest. As more and more Americans gain insurance coverage the greater, the demand will be for their time and attention. The American Academy of Family Physicians predicts that an additional 40,000 primary care doctors will be needed over the next 10 years.As time passes, this new ground breaking legislation is suppose to decrease the number of patients treated through our Emergency Rooms (ER), thus keeping the cost of healthcare down.
If there is any hope of this happening the number of (PCP) ’s has to increase before 2014, otherwise the patients that cannot get into see their (PCP) will resort to the ER for their non-urgent health issues, just to receive treatment. A cost analysis study was performed by the RAND Corporation and the results published on June 27, 2010.What they found was “Of all the proposals on the table that would expand health insurance to more Americans, the final health reform law included those that covered the largest number of people at the lowest cost to the federal government,” said Elizabeth A. McGlynn. Medicare and Medicaid (2010, June). The RAND corporation was also charged with analyzing the inner workings of the reform act, they where asked to evaluate the feasibility of the PPACA to see if it was structured differently would the cost to the federal government would be any less.A couple of possible scenarios that they reviewed and analyzed were; if employers with fewer employees were required to provide coverage or pay a penalty how would that influence the cost to our government.
Medicare and Medicaid (2010, June). In essence, the RAND Corporation found in their study that by increasing the fine to $1,200 per person CMS (Center for Medicare and Medicaid) could realistically insure an additional 4 million people per year. Additionally, there are physicians that feel disappointed that the PPACA did not address their issues or concerns, especially compensation.For the past year providers across America held their collective breathe while, they waited to see if Medicare was able to push for a 21. 2 % decrease in payments. In the meantime, providers are seeking additional support form the AMA (American Medical Association). Providers want the AMA’s support in getting legislation passed that would allow “private contract” rights with Medicare patients, which would allow doctors to charge fees that exceed Medicare rates, with patients paying the balance out of their own pockets or with supplementary insurance making up the difference.
Robeznieks, A. 2010, June). Furthermore, providers need to start preparing for more accountability when treating their patients. According to the PPACA, providers that are use to their current volume-focused, fee-for-service approach to practicing medicine will soon disappear. In the past, a provider was able to choose the manner in which they treated a patient. In an attempt to stop the raising cost and waste generated by providers in diagnosing patients some type of tracking system needs to be put into place. For centuries, medicine has been defined as the art and science of maintaining and restoring human health.
Just like artists who have unique styles and interpretations when creating sculptures or paintings, physicians employ distinctive care delivery methods. In fact, each physician delivers patient care in a unique manner, even for the same type of patient with the same clinical diagnosis and procedure needs. Goodroe, J.. (2010, June). Patient Protection and Affordable Care Act represents a major opportunity to achieve numerous key goals at once: improving disease prevention; reforming care delivery; and bending the cost curve of health spending while also realizing greater value for the dollars spent.Reform-based initiatives could produce major gains in a relatively short time.
The U. S. Department of Health and Human Services should develop an action plan detailing how the programs that the health reform law sets into motion throughout various agencies can work synergistically. It should also detail how best practices in finance and payment, in the organization and delivery of care, and in prevention can be expanded nationally. Thorpe, K. , ; Ogden, L..
(2010). Addressing the compensation issue, in these key areas is what has turned the tide for the opposition concerning the Healthcare Reform Act.Providers want to be compensated for doing their jobs, and doing them well. Thomas Jefferson, former President of the United States, said “All, too, will bear in mind this sacred principle, that though the will of the majority is in all cases to prevail, that will to be rightful must be reasonable; that the minority possess their equal rights, which equal law must protect, and to violate would be oppression. ” Whenever there is, change of this magnitude proposed there would of course be opposition. PPACA will provide healthcare, at a reasonable cost to over 40 million Americans, it will hold all providers to a higher quality of care, and inancially impede them if the care that they provide is not up to government standards, which have not completely been defined. Children will be allowed to remain on their parents’ insurance plans until they are 26.
Compensation to providers will be based on overall treatment of their patients with a bonus structure, still not ironed out, for getting patients healthier and then maintaining their health. Overall PPACA represents an obtainable reform with a little give and take on both sides of the party line as long as each side gives and takes equally.