The Affordable Care Act, also known as Obamacare, will affect many aspects of health care across the nation. Below are five ways the new law will influence procedures surrounding hospitals, doctors, nursing homes and insurers.
HOSPITALS
1 The Affordable Care Act allows the federal government to withhold Medicare payments from hospitals if too many patients return within 30 days of discharge for certain ailments such as a heart attack or pneumonia. This means there will be more focus on what happens when you leave the hospital following surgery or treatment. Instead of one quick phone call to see if you’re okay, the hospital may assign a nurse to make sure you fill your prescriptions and actually have a follow-up appointment with your regular doctor.
2 There will be more emphasis on improving the quality of care in hospitals by reducing complications from infections. This has been an industry priority for years, but now, poorly performing hospitals will take a financial hit if they don’t improve. In fiscal 2015, federal reimbursement rates will be cut by 1 percent to hospitals that have the highest rates of infection acquired in the hospital.
3 Hospitals are big businesses with a lot of moving parts behind the scenes. Imagine if your office had new policies to implement, with new partners, new billing, requiring a new set of reporting using new forms. And everyone needs to be trained in all the new procedures. Hospitals are already doing a lot of the training now.
4 Because of all the new regulations and changes to how hospitals are paid, look for more mergers and consolidation. Health systems such as Barnabas or Atlantic Health will benefit from focusing resources on clinics and urgent care centers as opposed to relying on stand-alone hospitals to generate all their revenue.
5 Hospitals are already in their third year of cuts to Medicare reimbursements. The savings were used to help pay for the new law. The thinking is that in the long term, that continued drop in revenue will be made up by the jump in new patients as more people get private insurance. In theory, that means fewer uninsured will show up for free treatment at hospitals — so-called charity care that has drained hospital coffers.
But will that happen in practice?
“The problem is those cuts have begun before we’ve had the chance to see the benefits of seeing more insured patients,” said Kerry McKean Kelly of the New Jersey Hospital Association. “In the end, we hope it all balances out, and it’s the perfect balance.”
Sources: Kerry McKean Kelly, of the New Jersey Hospital Association, obamacarefacts.com; accountablecarefacts.org
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