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MediGain Blog

With the results of the election just beginning to sink in, many in healthcare are already wondering what changes are in store for our industry. President-elect Trump vows to repeal Obamacare and replace it with something much more affordable to consumers. But how would that look? Here are the top three plans that have been proposed to replace Obamacare. 

Just because you have a full patient load doesn't mean you should put a halt on your marketing. It doesn't take long for changes to occur within your practice that alter your patient list and ultimately change the revenue you generate. Can you honestly afford to have slow spells when you yourself have financial obligations inside and outside of your practice?

Physician practices and ambulatory surgery centers (ASCs) preparing for ICD-10 will need to complete a variety of tasks,  many of which can be accomplished all at once through working with a revenue cycle management firm. Companies like MediGain that concern themselves exclusively with medical billing can provide the support necessary for a smooth transition to the new coding system. Working with such a company also means there is no need to retain or train in-house medical billing and coding staff in preparation for the switch, which can be expensive for resource-strapped centers.

Some 3.3 million people have signed up for health insurance through the marketplaces established by the Affordable Care Act (ACA), The New York Times reports.  The administration reported 1.9 million people had chosen health plans from the federal marketplace between October and January, and 1.4 million had elected plans for state-run exchanges. January saw 1.1 million people sign up for federal and state exchanges alike.There was a slight rise in the enrollment of young adults, which was a goal of the administration and health industry professionals. Younger enrollees are highly valuable to the plans, as they are usually both healthier and less in need of services that can become expensive.

Hundreds of thousands of consumers are newly insured, opening access to physician visits for people who may never have had the means to go anywhere but the emergency room. However, according to The Chicago Tribune, many of them may prefer to stick with what they know and continue to visit the ER for their health issues.

The Affordable Care Act (ACA) has made value-based reimbursement more common for private payers and Medicare and Medicaid alike. The results of Physicians Practice's 2013 Fee Schedule Survey showed reimbursement for physicians is trending downward - average commercial payer reimbursement for all office visits fell nearly 9 percent between 2012 and 2013. This presents an environment in which a change to reimbursement structures may be welcome. Though only 16 percent of respondents to the Physicians Practice survey said a shift in payment methodology would be beneficial to their practices, there's still time to evaluate what pay-for-performance - rather than pay-for-service - models might look like.

New data from the American Hospital Association (AHA) shows the cost of uncompensated hospital care rose 11.7 percent in 2012 to a total of $45.9 billion. While this statistic is not directly related to physician practices and ambulatory surgery centers (ASCs), it is indicative of a disturbing trend in the healthcare payments space. For the purposes of the study, the AHA defined uncompensated care as medical care service that was not reimbursed through any means, including charity care and bad debt.