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Affordable Care Act and Doctors Q and A

When the topic turns to the Affordable Care Act and doctors, a pair of issues always seem to come up and raise concerns about Obamacare’s effect on doctors and their practices.

The last time we took a look at some of the questions relating to the ACA and how it impacts patients, this time we’re taking a look at Obamacare’s effect on doctors.

Q: Do physicians get paid less to see patients covered by the ACA?

A: Physicians receive less in Medicaid reimbursement than they receive from private insurance or from patients who pay cash. Electronic health records

“The benchmark for physician fees is the rate the federal government sets for services provided to older Americans through Medicare,” according to a Kaiser Health News article. Private plans typically pay slightly more than Medicare, and Medicaid reimburses at a significantly lower rate.

Information on reimbursement rates are hard to determine, but the article reports that “information cobbled together from interviews suggests that if the Medicare pays $90 for an office visit of a complex nature, and a commercial plan pays $100 or more, some exchange plans are offering $60 to $70.”

The Affordable Care Act has added 6 million additional people to Medicaid programs across the country according to a July 17 New England Journal of Medicine report.

“Both primary care and specialty care physicians reported that their compensation increased slightly in 2013. Primary care physicians reported $232,989 in median compensation, and specialists reported $402,233 in median compensation,” according to the Medical Group Management Association annual survey. The 2015 survey will reflect the immediate impact of the Affordable Care Act and doctor salaries.

Q: Is there a shortage of doctors and medical students caused by the Affordable Care Act?

A: Several issues were already contributing to a shortage of doctors that was expected to grow. The impact of the Affordable Care Act is an influx of newly insured patients that further exacerbates the problem. “While factors like increased insurance coverage, a growing population, and increased utilization due to medical advances are part of the story, the driving force is the aging U.S. population,” according to the Association of American Medical Colleges.

A shortage of medical students is not an issue, although a cap on residency support by Medicare delays when a large percentage of medical school graduates are able to become independently practicing physicians. Attempts to raise the cap are currently making their way through the legislative process.

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Tom Prose

CEO at General Medicine, P.C.
As founder and CEO of General Medicine PC, the nation’s premier post-hospitalist care company,Tom Prose leads an exceptional team of internal medicine, geriatrics and healthcare administration specialists.