On June 4, 2013, I attended the program presented by the Center for Health Care Management and Policy at The Paul Merage School of Business, University of California at Irvine. The program titled “Impact of ACA Implementation on Hospitals, Physician and Physician Groups, and Insurers in Orange County” addressed the impact of the Affordable Care Act on various entities in the healthcare industry.
Here are some of the major takeaways from the event:
- The employer must offer medical coverage that is affordable to their full-time employees.
- The Act includes employer penalties if they do not comply with the law. The penalties can equal $2,000 per full-time employee (minus the first 30 employees).
- The Act includes provisions for individuals to maintain minimum essential coverage. This will increase the number of insured people seeking care.
- Historically, hospitals have built facilities, equipped them with the latest equipment, staffed them with physicians, nurses, and technicians, and then waited for patients to come in with a medical need. The focus will now be shifted to preventative care rather than providing care when needed.
- Under this new model, hospitals will receive decreased reimbursements and will still be expected to deliver the same services. The hospital groups are looking to modify their traditional approach by setting up small facilities in the community that can provide the initial contact/examination of the patient and his needs and assess the treatment plan in a lower-cost model.
- Additionally, hospital groups are attempting to form/partner with physician groups through acquisition so the hospitals can receive a portion of the physician revenue stream. In many cases, they will compete directly with the physician providers. This directly conflicts with the physicians who historically referred their patients to the hospital.
Due to this Act, there will be sweeping changes in the years to come.
Don’t hesitate to contact Greg Lewis for further information at (714) 569-1000.
