tci Medicare Compliance & Reimbursement - 2012 Issue 18
Legislation: Expect Some Short Term 'Preventive Care' Bonuses
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Article Overview
This article reviews anticipated near-term and longer-term effects of the Affordable Care Act on healthcare providers, with emphasis on family medicine, internal medicine, pathology, and clinical laboratories. It discusses broad operational and financial implications for practices and labs, including preventive service demand, billing workflow, fee schedule pressures, and payment reform trends. The piece is intended for coding, billing, compliance, and reimbursement professionals who need a high-level view of policy-driven changes affecting provider organizations.
Why This Topic Matters
It helps readers understand which parts of the healthcare revenue cycle and practice management environment may be influenced by national health reform, especially where preventive care, claims processing, and reimbursement policy intersect.
Article Sections
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Look Ahead to Greater FP Demand
Discusses anticipated changes in demand for primary care and the broader effects on family practice and Medicaid patient volume.
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Expect Doctor-Patient Relationship Changes
Examines possible shifts in provider-patient dynamics and practice workload associated with insurance coverage changes.
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Plan for Billing Changes
Covers expected administrative and billing workflow impacts, including claims handling and reporting-related workload.
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Prepare to Wait and See
Summarizes uncertainty around the law's future and the possibility of additional legislative or executive changes.
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Look for Cancer Screening Uptick
Addresses preventive care trends and increased utilization of screening and other covered services in laboratory settings.
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Don't Expect Fee Schedule Relief
Reviews broader reimbursement outlook for physician and laboratory payment systems and the lack of immediate relief from fee schedule pressures.
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Anticipate Demise of 'Fee for Service'
Discusses movement toward coordinated care and incentive-based reimbursement, along with related compliance and payment policy changes.
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Heed Your Own Healthcare Costs
Highlights the need for providers and laboratories to consider the law's effect on their own operating expenses and employee benefits.
What You Will Learn
- How national health reform may affect primary care demand and Medicaid-related workloads
- What broad practice management changes may follow from expanded insurance coverage
- Which billing and claims administration areas may experience increased pressure
- How preventive care utilization may affect laboratory and screening service volume
- Why reimbursement and fee schedule concerns remain important under the law
- What broad shifts in payment models and quality-driven reimbursement are being discussed
- How provider organizations may need to plan for rising internal healthcare costs
Who Should Read This
- Physicians
- Family medicine practices
- Internal medicine practices
- Pathologists
- Clinical laboratories
- Medical billing staff
- Coders
- Compliance professionals
- Practice managers
- Reimbursement analysts
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