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Survey: Many Doctors May Duck Out of ACA Participation

By Stewart Gandolf, Chief Executive Officer

affordable healthcareThe fast-approaching New Year is shaping up to be even more challenging for many doctors and patients as well.

In a market already strapped by a growing doctor shortage, a new report by the Medical Group Management Association (MGMA) forecasts nearly 25 percent of doctors may turn their back on Affordable Care Act (ACA) plans due to low reimbursement and high costs.

In that environment, increased competition for doctors seeking well-insured patients is a serious marketing consequence.

Rewind exactly one year. Further, what if the government were to force doctors to accept ACA-covered patients? An opinion column headline by public policy observer Merrill Matthews, PhD, [via Forbes.com] asked: When Will The Government Start Forcing Doctors To See Obamacare Patients? At the time, Dr. Matthews wrote:

“Patient access to doctors is approaching a perfect storm of decreased physician supply, more demand for medical care—especially after Obamacare kicks in—and doctors increasingly refusing to see low-paying Medicare or Medicaid patients.  If the ‘promise’ of Obamacare’s access to health care is to be kept, government will eventually have to force doctors to accept Obamacare-covered patients.

“[A] growing number of doctors are refusing to take new Medicaid or Medicare patients, and there is every reason to think the same will happen under Obamacare.”

Fast forward to 2015. About 214,524 doctors are likely to not participate in new plans under the ACA, according to the Medical Group Management Association data. That number would represent 24 percent of the 893,851 active professional physicians.

As one example, an estimated seven out of 10 California physicians reportedly have not participated in Covered California plans--a state with the highest number of ACA plan enrollees.

Patients with new ACA insurance will be challenged to find (willing) providers. And when demand exceeds supply, some patients may change their coverage, resort to paying cash, or seek care via hospital emergency departments.

Medical practices, on the other hand, are likely to find the already-intense competition for well-insured patients to grow worse. Taking on additional patients to recover lost revenue is like the flawed notion that business can “lose a dollar on every customer and expect to make it up in volume.”

Notwithstanding that some doctors will opt to retire or seek other employment options, marketing savvy providers who expect to stand their ground can expect an up-tick in the intensity and the quality of marketing from competitors.

Medical practices will continue to become more skillful and sophisticated in their ability to differentiate their practice and win new (and financially desirable) cases and patients.

Lonnie Hirsch

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