PHYSICIANS NEWS DIGEST recently reported that the provisions of the Affordable Care Act (ACA) will dramatically expand health insurance coverage such that in 2014 physicians will experience a revenue surge.
The publication cited Centers for Medicare and Medicaid Services' study that forecasted a 5.6% growth rate in public and private spending on physician and clinical service in 2013 and 8.9% growth in 2014. The study forecasts that by 2020, an estimated 30 million individuals will gain coverage under ACA. Spending increases will be created by individual and small business purchases of health insurance with federal assistance through state-based exchanges, and Medicaid broadened eligibility requirements.
The study also noted that "many of the newly insured will be younger and healthier, on average, than those already insured" and will therefore use "lesser intensive" healthcare resources like physicians and prescription drugs. Accordingly, hospital and more intensive service spending will grow less. The study contains a cautionary note as well - the anticipated growth in some healthcare sectors can not overcome the very substantial Medicare pay reduction of almost 30% set for 2012.
The possibility of significant changes in the future reimbursement structure and the number of patients with insurance may bring somewhat dramatic swings to the revenue streams of various physician specialty practices. Understanding how these may impact each practice (more patients equals more staff, more space, more purchases of office and medical equipment) will be of paramount concern. Ongoing business planning is always advisable for healthcare professionals. With so many imminent changes, it is more essential than ever.