Health Insurance Exchanges and How Your Practice Might Face Potential Financial Hardship

EDWARDSVILLE, Ill. - Oct. 3, 2013 - PRLog -- Starting October 1, 2013, qualified U.S. residents will be able to start enrolling for insurance participation through the Health Insurance Exchange.  Their coverage will begin as early as January 1, 2014.
Many physicians feel unprepared for the new evolution of the healthcare industry.  There has been very little public awareness of these new health insurance options, and everyone seems to have their own opinion as to what the government is going to do.
Not all states have made public the list of health insurance plans that will be represented in their Health Insurance Exchange, and open enrollment starts this coming Tuesday.
Are you aware that there has already been talk of Health Insurance Exchange plans putting heavy restrictions on which providers and provider networks can be selected as in network providers?  Many physicians are potentially going to be financially devastated by the changes to come if they do not prepare and partner now with resources that will allow them at minimal increased cost to report and meet the demands of this new system.
I was at a healthcare conference over this past week where Dr Ezekiel Emanuel, pioneer of the Health Care Reform, was presenting his views on the future of healthcare in America.  His stance was that we need to utilize less costly procedures, older technology, and more triage work and less physician one on one with patients.  He also stated that, in his opinion, our payment system needs to go to a more bundled and/or capitated payment plan.  He wants physicians to get a flat amount of money to manage a patient’s care in hopes that the physician will be forced to reduce their face to face time visits, drastically reduce outside referrals, and treat their patient with a minimal amount of tests and procedures.  He also stated that, in his opinion, the one to five doctor private practices will become nonexistent and everyone will need to be part of a larger model similar to the emerging ACO’s.
What seems most ironic, is that while I was sitting in the Orlando Airport waiting for my plane to depart, I read an article stating that Anthem BCBS of Missouri is not including BJC HealthCare hospitals and providers in their plan products offered through the Health Insurance Exchange because they state that BJC facilities are too expensive for them to cover the costs for their insured.  The network for the Anthem BCBS plans, which will be sold through Missouri’s “Obamacare” marketplace, does not include BJC HealthCare and its 13 hospitals – among them Barnes-Jewish Hospital and St. Louis Children’s Hospital among others.  This is a world-renowned hospital system and their facilities and providers are always ranked in the Top 100 in the United States annually.  This will greatly affect the current care of patients established in these systems and hospitals and will force hundreds of thousands of insured to seek out new doctors and alternative treatment options.
With the impending healthcare changes, not to mention the upcoming changes of ICD-10, it will make it extremely difficult for the solo practitioner and smaller physician groups to survive financially on their own.  How can you overcome Dr. Emanuel’s thinking without succumbing to his thinking?  You must partner as soon as possible with services that are able to economically help you provide the same data and reporting that the emerging ACO’s will provide.  How do you economically do that?  We are confident that our Medical Billing Solutions, Inc. clients will be staying in business because they have someone on their side “playing the game” and advising them on which direction to go so they can come out on top.  By partnering with Medical Billing Solutions, Inc., we can economically provide you with solutions that will fulfill the needed monitoring and reporting and often increase your revenues as well.  We can assist you in staying on the cutting edge of PQRS, Meaningful Use, up to date coding changes and efficiencies, etc. allowing you to offer the same cost effective care that the larger groups offer.  Partnering with MBS will allow you to reap the rewards of a larger resource but keep your autonomy in private practice that is trying to be taken away from you.
If you are concerned about your practice being able to financially weather the upcoming changes, please feel free to e-mail us at info@mbs-inc.com to hear how we can help by partnering with your practice to provide a solution to your financial needs.  Do not wait!  Email or call us today so that you can see how we can benefit you and your practice.
Medical Billing Solutions, Inc. will continue to report on Health Insurance Exchange information as it becomes available.  Please continue to review our MBS Newsletters carefully so your practice can remain up to date on the most current information available.
Call us today at 1-888-810-0098 or visit www.medicalbilling4u.com to learn more.