For medical practices, insurance verification means knowing about their patients’ coverage in order to be able to bill for the services provided to them. For consumers, the current concern is how much they will have to pay as insurance premiums under Obamacare to keep their coverage active and get the healthcare services they need.
According to recent reports, consumers will see many changes in Obamacare. As Americans begin to enroll in or change 2017 marketplace health insurance on Nov 1, they will face higher premiums but fewer choices as insurers are backing out of several states. Medical practices need to be aware of these changes which will impact their patients and their bottom line.
CNN Money reports that the effect of an average 22% rise in benchmark plan prices will vary by state – from modest increases to severe hikes. The key changes that the health insurance scenario will witness are as follows:
- Premiums have increased by an average of 25 percent in the 39 states using the federally run insurance exchange.
- Obamacare prices have risen by 40% or more in 10 states: Alabama (58%), Alaska (29%), Arizona (116%), Illinois (43%), Kansas (42%), Montana (44%), North Carolina (40%), Nebraska (51%), Oklahoma (69%), Pennsylvania (53%), and Tennessee (63%). In Minnesota, which runs its own health exchange, premiums will increase by 56%.
- Up to 33 states will have fewer insurers in 2017 than they had in 2016.
Arizona and Texas have lost six insurers, while Kentucky and Ohio have lost four each. Alabama, Alaska, Oklahoma, South Carolina, and Wyoming – will have only one insurer offering exchange coverage in 2017.
- Customers in 68.7 percent of U.S. counties will have only one or two insurers. Alabama, Oklahoma, and three other states will only one insurer.
Reports say that 85 percent of Obamacare enrollees receive taxpayer-funded subsidies for their coverage and therefore will not be hit by the full price hike. Enrollees can use their subsidies to buy lower – priced bronze or silver plans and choose one for $100 or less a month on the federal exchange. However, according to a report published by The Daily Signal, of the 17.7 million Americans who had coverage in 2015, up to 10.3 million (58 percent) paid the full cost on their own.
It’s a fact that Obamacare has increased health insurance coverage across the nation. Statistics from the Centers for Disease Control and Prevention show that the share of people without health insurance has come down from 18% in 2010 to 10% in 2016. Nevertheless, a recent survey by Kaiser Health shows that, in 2017, there is still considerable scope for increasing coverage among children and the low – income population – groups that qualify for the greatest assistance under the Affordable Care Act (ACA).
How has Obamacare impacted medical practices? How will the current changes affect them? Reports say that with the ACA, physicians face additional burdens such as: reduced incentive payments, Medicaid expansion and tighter payments, bundled payments and reimbursements based on metrics. Moreover, they have to deal with new regulatory reporting, disclosure and compliance requirements. Under Obamacare, patient benefit verification has also become a major challenge for physicians’ offices. The staff has to spend a long time on the phone verifying patients’ coverage and making sure that their coverage is active. The impending changes in enrollee coverage and services can make things even more cumbersome.
Many physicians can adapt more easily to these developments, manage their new workload, and reduce risks of no – payments by outsourcing medical billing and insurance eligibility verification to companies that specialize in these tasks.