Though the future of the Affordable Care Act is uncertain at the moment, its impact on physicians and their practices was significant in 2016. In October, the Obama administration predicted monthly ACA marketplace enrollment will hit 11.4 million in 2017. This represents a 9 percent spike from the 2016 average monthly enrollment.
Here are 12 things to know about the ACA's impact on physician practices in 2016:
1. Physicians' approval rating of the ACA declined for the first time in several years. Only 71 percent of respondents gave the ACA a passing grade in 2016, according to the Medicus Firm's 13th annual Physician Practice Preference and Relocation Survey.1 The survey polled a total of 2,413 providers representing more than 21 specialties.
2. A Statista report2 shows that in 2016 physicians graded the ACA as follows:
• A: 3.2 percent
• B: 20.1 percent
• C: 28.4 percent
• D: 22.1 percent
• F: 26.2 percent
3. A Jackson Healthcare survey,3 which polled 1,352 physician, found that the ACA increased overhead costs for 61 percent of respondents and administrative work for 60 percent of respondents. Although the ACA was designed to decrease healthcare costs, 51 percent of physicians reported the law's positive aspects have not outweighed the negative aspects.
4. Only one-third of physicians reported that the ACA hasn't had an impact on their practice, noted Physicians Practice's The Great American Physician Survey 2016. Around 39.6 percent reported that deductible collection is now more challenging and 12.7 percent said certain insurers dropped them.
5. Additionally, 20.2 percent of physicians reported they have a higher patient volume and that 21.5 percent see more chronic pain patients, according to The Great American Physician Survey 2016. Around 7.3 percent dropped out of Medicare, Medicaid or other programs, and 23.8 percent received claims denials because the patient didn't pay his or her premium.
6. As healthcare spending continues to climb, some expect the prevalence of high-deductible plans to increase. But patients with high-deductible policies are grappling with significantly greater out-of-pocket costs. Kaiser Family Foundation reports the average annual out-of-pocket costs per patient rose almost 230 percent between 2006 and 2015.
7. Providers and healthcare organizations take on bad debt when patients fail to satisfy their financial obligations. For insured patients, management consulting firm McKinsey & Company estimated the rate of bad debt is increasing at well over 30 percent each year in some hospitals.
8. Most physicians in private practice do not favor the ACA — only 20 percent view the law favorably; 26 percent of group practice physicians and 35 percent of hospital-based physicians feel the same, according to a CompHealth survey.4
9. A majority of physicians in private practice also tend to have a negative perspective on how the ACA impacts their work. Approximately 86 percent believe they are not being properly compensated for their time, as compared to 75 percent of group practice physicians and 72 percent of hospital-based physicians who believe the same, the CompHealth survey shows.
10. The 2016 Survey of America's Physicians indicates that, in practical terms, the majority of physicians remain in a fee-for-service world. When asked if any of their compensation is tied to value/quality-based metrics such as patient satisfaction or adherence to treatment protocols, 45.1 percent of physicians said no, 42.8 percent said yes and 12.1 percent were unsure.5
11. The same survey shows that 56.3 percent of physicians indicate they are very or somewhat unfamiliar with the the Medicare Access and CHIP Reauthorization Act, while only 19.9 percent indicate they are very or somewhat familiar.
12. Approximately 43 percent of physicians indicate they participate in a state/federal exchange, while 53 percent do not participate and have no plans to or are unsure whether or not they participate, according to the 2016 Survey of America's Physicians.
References
1Medicus Firm's 13th annual Physician Practice Preference and Relocation Survey
http://www.themedicusfirm.com/the-medicus-firm-releases-annual-physician-practice-preference-survey-for-2016
2Statista
https://www.statista.com/statistics/613933/affordable-care-act-rating-by-physicians/
3Jackson Healthcare
http://www.jacksonhealthcare.com/media-room/news/doctors-say-aca-increasing-cost-of-healthcare/
4CompHealth survey
http://www.comphealth.com/about-comphealth/in-the-news/press-releases/comphealth-aca-study#.WDtQGKIrJmB
5Physicians Foundation's 2016 Survey of America's Physicians
http://www.physiciansfoundation.org/uploads/default/Biennial_Physician_Survey_2016.pdf