Most people are well aware of how Obamacare, or the Affordable Care Act (ACA), affects the general populace. All Americans must now carry minimum essential coverage where health insurance is concerned or face penalties. To help all Americans select insurance policies, the federal government and individual states have created healthcare marketplaces to provide affordable healthcare coverage for all, including those who were previously unable to gain insurance coverage due to low income or pre-existing conditions. As a result, Obamacare has affected the healthcare system as a whole, contributing to some pretty major changes in both the way health insurance is administered and how care is delivered. Hospitals, like patients and insurance providers, have had to adjust in order to be in compliance with Obamacare.
Hospitals have already started to see some of the effects of Obamacare. As predicted, the last few years have seen a host of mergers and acquisitions as hospitals try to make the most of a changing system of seeing patients, treating them, providing aftercare, reporting, and handling billing. Perhaps one of the best aspects of healthcare reform has been the onus to provide preventive care as a means of reducing the need for pricy emergency medical services. As a result, hospitals that comply with new forms of oversight will continue to receive financial support from Medicare and Medicaid, while those that fail to meet standards could be denied funds.
For example, Medicare may withhold payment for treatment if patients seen for certain conditions return to the hospital within 30 days. If a patient that has a heart attack returns to the hospital with another incident within 30 days of the first incident, the hospital could be denied payment for all treatments through Medicare. The good news is that this has led hospitals to rethink treatment and aftercare, ensuring that patients are scheduled for follow-ups or that they are contacted after in-hospital treatment to make sure they are following instructions and that they are recuperating as expected.
This could be why so many hospitals have started merging with clinics – these facilities could be a means of providing additional preventive and aftercare support services that aren’t necessarily available in a hospital setting or that would cost a lot more for patients visiting doctors in the hospital, as opposed to a capable nursing staff at a clinic. Additionally, hospitals with high rates of infection could be penalized as part of an ongoing effort to increase the quality of care patients receive.
Hospitals have also had to spend time and money training staff in the new policies, reporting, and billing practices required under Obamacare, and they’ve seen cuts to Medicare payments, which are now going to fund healthcare reform. The idea is that hospitals will see a reduction in payout now, but be able to recoup costs down the road thanks to an increase in patients utilizing new insurance policies for the purposes of preventive care, not to mention a decrease in the number of uninsured emergency patients that hospitals have to treat virtually free.
It is easy to see why so many consolidations, mergers, and acquisitions have occurred in the last few years then, with hospitals losing funds and waiting for anticipated returns to start rolling in. All in all, these changes should work to the benefit of both patients and hospitals, provided hospital conglomerates don’t use the newfound leverage of local monopolies to increase prices on their patients.
Submit your questions below or start a conversation in the comments!