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Revenue Cycle and ObamaCare: What Is the Projected Impact?

ObamaCare, even the title is an oxymoron. There is nothing I can see in my review and analysis of the “PPACA” H.R. 3590 that resembles “care”.

Nancy Pelosi put the “local framework” of this legislation into context with her infamous statement, “we need to pass this bill in order to find out what is in it”. Talk about ready, fire, aim!

Unfortunately for those of us in the medical and medical support service fields, the PPACA is now the law of the land. Rather than burying our heads in the sand, it is critical that we understand and prepare for the direct and indirect effects the PPACA will have to the medical provider revenue cycle.

What percentage of your total A/R is patient A/R?

The National average patient A/R percentage of the total A/R for non-hospital medical practices is 16.4%.

How much are you currently collecting on your patient A/R?

Although it varies by specialty, on average, non-hospital medical practices collect 17.8% of the money owed by patients.

  • Gastroenterologists 26.9%
  • Urologists 24.9%
  • Radiologists 19.6%
  • Oncologists 07.9%
  • Surgeons 14.7%
  • Cardiologists 12.8%

When the “prototype program for ObamaCare”, Romney Care, was introduced in MA several years ago, the subsequent increase in patient accounts receivable was an average of 30%.

The projected patient A/R increase due to ObamaCare Nationwide is expected to be 27.5%.

If you are currently collecting less than half of your outstanding patient A/R, can you really afford to have your insurance A/R decrease and your patient A/R increase by 27.5%?

In the last several years, even before ObamaCare, the patient receivable A/R for most healthcare providers had become an escalating issue.

5 years ago: Medical practitioners were conditioned to live off of co-pays and insurance reimbursements. Very little thought or effort was put into collecting on the patient responsibility.

Today: 83% of the physicians interviewed said the A/R portion of their overall receivables has gone up more than 15% in the last 5 years. With lower insurance reimbursements and much higher patient deductibles, providers have expressed that they can no longer afford to live off of insurance reimbursements and co-pays alone.

Medical providers have come to realize that they can no longer simply write-off the unpaid patient balances and expect to stay in business. ObamaCare will merely intensify this already growing problem. Partnering with a revenue cycle company specializing in patient billing and collections will significantly mitigate this threat.

Source by Samara L Keaton

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