How Does Obamacare Affect Doctors, Nurses and Hospitals?

Written by Sandy Baker
Written by Sandy Baker

Health insurance blogger, Sandy Baker, has a long-term history online that includes publications with companies such as Marriott Hotels and The New York Times.

A smiling group of doctors and nurses.

The Affordable Care Act, also known as Obamacare, receives a lot of attention in relation to how it affects individuals. This law requires most Americans to obtain healthcare coverage, either through employment or through a private or network plan. While the focus is on the individual, other entities are affected as well. How does Obamacare affect doctors? This new U.S. law affects a variety of people and businesses and in several ways. Consumers are asking questions about whether they can keep their current doctors. Some doctors wonder what this means to their patient load, income, and the overall health of their practice. It's important to break down the various ways the law affects doctors and patients alike.

What Does Obamacare Mean for Doctors Themselves?

In many instances, the Affordable Care Act may help doctors. Millions of Americans were without health insurance prior to passage of the ACA. The the new law enables individuals to get the coverage they need to actually receive healthcare. Most doctors want patients to be seen. This increases the number of people who are likely to seek medical care when they need it. Prior to the law's passage, many men, women, and children went without care because they could not afford it.

As a result, the passage of Obamacare means doctors are likely to experience an increase in the number of patients they see. Customer counts, so to speak, are likely to rise. It's also important to note that only a few doctors are associated with some of the limited networks available through the new law. This could lead to a shortage of doctors available to some patients and too many patients for the doctors in such networks.

What Does Obamacare Mean for Physicians in Relation to Patient Decisions?

According to the National Physicians Alliance, a few key factors will play a role in patient care now that Obamacare is in place. Doctors and patients are affected in these ways:

  • The law prohibits denial of care for and discrimination against patients with pre-existing conditions This means doctors have the ability to treat patients who might otherwise have been unable to seek medical attention due to inability to qualify for medical coverage.
  • Without lifetime limits on insurance coverage, doctors can provide more thorough examinations, tests and screenings as a step towards diagnosis or treatment of the patient.
  • Patients may no longer have to wait until next year to get the care they need. Obamacare eliminates annual limits on insurance, so doctors will no longer have to wait to see patients who previously would have had to wait until the following year to access new medical coverage limits.

What Does Obamacare Mean Financially for Doctors and Their Practices?

Some reports indicated that doctors would see lower payments once Obamacare went into effect. Yet this may not be the case. In some instances, Obamacare may lead to improved financials. One key reason for this is that Medicare pays a 10% bonus for primary care services and a 10% bonus to general surgeons in areas with a shortage.

Doctors with small practices can also save money, like most other businesses, by shopping for insurance for their employees through the health insurance marketplace, potentially decreasing costs. The marketplace allows small practices to join together to shop for such coverage.

Accountable Care Organizations May Limit Solo Practices

Many hospitals began purchasing smaller doctor practices prior to Obamacare going into effect. This was because the new law endorses Accountable Care Organizations, which bring together smaller practices. Many solo practices have worked to move towards larger ones, mainly because the cost of implementing policies and procedures under the new law is burdensome. This includes increasing regulations, the use of new electronic health records and shifting referral patterns.

Some doctors believe this is bad for business, citing a similar trend toward hospitals buying out doctors that occurred in the 1990s. Doctors working as employees of hospitals are likely to work less, leading to decreases in wages due to lower productivity.  This kind of consolidation is not always beneficial to the finances of doctors.

Even More Changes Expected for Doctors

Obamacare will impact doctors in many other ways. What are the more general impacts of the new law?

  • Doctors will be likely to spot health problems early, due to patients coming in for the annual physicals made available to them by their newfound healthcare coverage.
  • Doctors must make the transition to electronic medical records. Though many practices have made this move already, those that have held off will need to make the investment and switch now. Some financial incentives are in place to help with this switch. Nevertheless, the process is time-consuming and very expensive, making it a financial strain on older doctors with extensive medical records.
  • Doctors will be able to continue providing care for children who have chronic ailments. Previously, many children with these conditions reached their lifetime maximum insurance payments very early on, leading to limited medical access once benefits ran out. With the removal of a lifetime cap, this is no longer a concern.

In short, doctors will see patients more often, potentially spotting medical conditions sooner. New regulations and electronic records are likely to add to the cost of doing business. And, in some cases, doctors who fail to provide adequate care may see limitations in Medicare and Medicaid payments.

What Does Obamacare Mean for Nurses?

Nurses are also likely to see an impact from Obamacare. The American Nursing Association, and many of its members, believe that access to high-quality healthcare is something that more people need. From that standpoint, nurses will now see more patients with coverage. That could mean the following:

  • More patients seen on a daily basis. That's simply because there are more people who have access to healthcare.
  • More preventive care appointments, which are often nurse-led. Nurses are likely to see a push towards preventive care services in many practices.
  • More paperwork in terms of meeting the law's requirements for reporting
  • Possible increased demand for traveling nurses, who move from place to place to meet needs in response to shortages. This may occur as hospitals work to fill openings in order to meet preventive care requirements and demands.
  • With Medicare and Medicaid remaining as large components of Obamacare, many RNs will see a push toward increasing education to meet demands within the industry. It may even be likely that the American Nursing Association will increase grant opportunities to push nurses towards getting the required education.

How Does Obamacare Affect Hospitals?

To further explore this topic, it is important to look at the effect of the new law on hospitals. One key way this law impacts hospitals is by withholding Medicare payments from hospitals that see too many patients returning within 30 days of discharge for specific ailments, such as pneumonia and heart attacks. Hospitals must ensure that patients are healthy enough to go home, and must also improve post-surgical treatment and services to decrease the likelihood that patients will need to return. This may mean that hospitals will need to assign outpatient nurses to ensure patients are following doctor's orders even after discharge.

There's no doubt that quality of care can increase in hospital settings when there's a risk of losing funding. In 2015, reimbursement rates will be cut by a full percent to hospitals that have high infection rates.

Numerous changes will occur behind the scenes, including new training and potentially new mergers to minimize costs and streamline efficiency. Hospitals may also see a decrease in the number of patients who arrive to receive treatment without any method of payment. That's because more people will have coverage.

Obamacare Affects Patients and Doctors at All Levels

The requirement to obtain healthcare makes a big difference in the way people live their lives. While it is an added expense, it may also mean better levels of care from doctors and hospitals. At the same time, it means significant changes for doctors, some of which could be too costly for them to keep private practices open. Though salaries may be impacted, some doctors are happy to see plans in place that ensure patients are getting the medical care they need for early diagnosis and long-term treatment.

Do You Have a Plan in Place?

Americans who need a plan are able to obtain health insurance through independent insurance agents on the Trusted Choice® network. These quality agents are available to provide answers to questions and guidance for all people who need to seek out coverage that is in compliance with the law. Because these agents can work closely with individuals to ensure that they have the most recent updates and access, Trusted Choice agents are the ideal choice for most Americans searching for coverage. These agents do not work for the government or for insurance companies. They work for individuals. Call a Trusted Choice member today to learn more about the policies and options available to fit your needs.

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