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Obamacare Increased Collections, Decreased Visit Volume
Coverage expansions resulting from the Affordable Care Act have not had a negative financial effect on medical practices. Instead, primary care physicians reported increased collections and decreased visit volume, according to athenahealth
Higher reimbursement rates as a result of the Affordable Care Act have led to increased collections for primary care physicians (PCPs) in both Medicaid expansion and non-expansion states in 2014, according to a report from athenahealth and Robert Wood Johnson Foundation.
For PCPs in non-expansion states, collections increased 3.3% and in expansion states collections increased 3%. However, both groups saw a decrease in visit volume, although it was to a smaller degree in expansion states (0.3%) compared to non-expansion states (1.3%).
The insurance segments that drove collection increases differed in expansion and non-expansion states. In states that haven't expanded Medicaid, more than half (57%) of the increase in collections was attributed to commercially insured patients between the ages of 41 and 64 years. In both sets of states, Medicare was a primary driver of increased collections: the program accounted for 41.4% of the increase in non-expansion states and 39.4% in expansion states.
"Overall, our data suggests that the coverage expansion provisions of the ACA have not had a negative financial effect on medical practices," the authors of the report concluded.
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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Need for Pharmacogenomic Testing in Mental Health Care Explored at AMCP 2024
April 17th 2024Presenters from Mayo Clinic discussed the benefits of implementing pharmacogenomic testing in mental health care for the betterment of patient outcomes, reducing medical costs, and more at the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting.
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Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
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Study Highlights Disparities in Access to In-Network Mental Health Care vs Medical Care
April 17th 2024While health plans often employ reimbursement rates as a tool to incentivize provider participation within their networks, study results showed reimbursement rates for office visits with medical/surgical clinicians were on average 22% higher than behavioral health clinicians.
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