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Consequences of the Accountable Care Act [PP-ACA]
By Dr. David Edward Marcinko MBA CMP™
[Editor-in-Chief]
There is a fair amount of activity that will take place in the next 24 months in response to ICD-10 transition, healthcare reform, Accountable Care Act (ACA), meaningful use compliance and its financial incentives, and other regulatory issues that will require system or software upgrades to support the new efforts.
Some ACA Examples
As an example, The Affordable Care Act is sure to significantly alter reimbursement structures and delivery of care.
Below are several areas that will be affected:
- With the projected increase in patient volumes, the associated cost of about 62% will emanate from Medicare cuts: $162 Billion through reducing fee-for-service Medicare payments; $136 Billion from setting Medicare Advantage rates based on Fee-for-Service payments; and $36 Billion from cutting hospital Medicare/Medicaid disproportionate share.
- Compliance reviews will be increased through the Recovery Audit Contractors (RACs) where Centers for Medicare and Medicaid Services (CMS) expect to obtain $2.9 Billion in additional savings. With the RAC in place, hospitals and providers need to increase their focus and attention in improving documentation quality and validating medical necessity to substantiate their reviews.
- Reduced payments for readmissions and Medicare penalties for poor outcomes can and will affect the bottom line for both hospitals and providers in the future.
- By 2015, more than 19 million uninsured will receive coverage and in 2016, another 11 Million uninsured will be insured. This will create more patients per hospital/provider and will require more full-time equivalents to support the revenue cycle process of registration, documentation, billing and collection.
- With the ICD-10 conversion will create a more complex requirement for documenting diagnoses and will require software modifications for hospitals and providers as well as significant training.
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[Our Forthcoming Book]
More:
- Healthcare Promises [aka ACA]
- With Obama Election Win “Mr. Market” Weighs in on the ACA Equity Winners and Losers
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Conclusion
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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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Filed under: Book Reviews, Health Insurance, Health Law & Policy |
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 
How much is the ObamaCare penalty?
Starting in 2014, if you do not have health coverage, you will be penalized when you file your tax return the following year.
For an individual, the fee is a minimum of $95, or 1 percent of adjusted income — whichever is greater. For a family, the minimum penalty can’t be more than $285 — but it can go as high as 1 percent of adjusted family income.
Within two years, there’s quite a jump. In 2016, the penalty is $695 for every adult, and the minimum penalty for a family is capped at $2,085.
However, it can be as high as 2.5 percent of the family income — whichever is greater.
Dr. David Edward Marcinko MBA CMP™
http://www.CertifiedMedicalPlanner.org
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Healthcare Additions in Budget Law Pleasantly Surprise Providers
Congress’ long-awaited budget deal, passed before dawn last Friday, serves as the most significant piece of healthcare legislation since President Donald Trump took office. The extensive healthcare package, hammered out largely behind closed doors in the Senate, in many ways took Washington by surprise.
Among its provisions were an extra four years of funding for the Children’s Health Insurance Program, a repeal of the Affordable Care Act’s Independent Payment Advisory Board, and a provision to accelerate the closure of what’s known as the Medicare Part D “donut hole” for seniors.
Joe
Source: Susannah Luthi, Modern Healthcare [2/9/18]
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