Providers: Shifting Landscape and Mindset

As a result of the Affordable Care Act as well as other healthcare legislation, a shift is occurring in healthcare from the provider’s perspective. In order just to survive (not even prosper), physicians are changing the way they conduct business and choosing which patients will be seen.

Shifting Landscape and Mindset – Changes in Medicare

Medicare reimbursement is certainly on the forefront. Reductions, even if 1% or less, can drastically affect a provider’s bottom line. Consequently, some providers are limiting the number of Medicare patients seen by their practice. Some providers have completely eliminated access to these patients.

Shifting Landscape and Mindset – Changes in Medicaid

Closely behind Medicare are Medicaid patients. Reimbursement has traditionally been much lower than Medicare. Following suit, many providers are reducing the number of Medicaid patients seen as well.

Shifting Landscape and Mindset – Additional Administrative Responsibilities

The amount of administrative tasks and time required to meet all regulatory compliance have increased. This time is generally considered non-productive time and billed at substantially lower rates than productive, if billed at all.

Shifting Landscape and Mindset – 180 Degree Change in Delivery System

The entire delivery system is evolving from a fee-for-service mentality to a fee-for-value mentality. While traditionally providers were more profitable due to the volume and quantity of patients seen, models are now focused upon quality outcomes and the value perceived by the patients.

Below are some interesting statistics as provided by Capson Physician Insurance: