Adjusting To The Affordable Care Act

I can’t help but wonder how many of us in healthcare know enough to respond honestly to our patients’ burning question: “Can you help me understand the Affordable Care Act and how it affects me?”

For the answer to this question, sooner or later (if they haven’t already), your patients will turn to you for help. Regardless of your political position or how the ACA has impacted your practice, you should be able to give patients helpful, relevant information.

We all realize there are going to be adjustments and learning curves and unending administrative efforts. Granted, insurance reimbursements will temporarily be in flux but patients don’t want to hear our complaining nor does it serve a purpose. Admittedly, I am not directly involved in the rollout of the ACA program but I was very much a part of what felt like unrelenting Medicare changes.

It seemed like every other day, there was a program modification — whether it was coding, policy, forms, you name it — and it was no bed of roses keeping up with new requirements. As I recall, none of us in podiatry accepted these changes with a wink and a smile. Some looked for ways around these changes but most accepted them, adapted and moved forward. For our own good, we found ourselves continuously educating our patients on the changes in their coverage. So confusion and criticism, you see, are not limited to the ACA.

What really convinced me of our lack of understanding was when I opened up this topic for discussion at a recent assistant conference. I sensed immediate frustration as the assistants blurted out their anxieties and trepidations of something they plainly knew very little about.

“The ACA is going to be a disaster for our practice!” exclaimed one assistant.

I asked in what way. “I don’t know. It just is.”

Another assistant said, “Oh, I have no idea how we’re going to handle all the extra patients!”

I asked, “Do you currently have patients that have ACA coverage?” She confirmed she did.

“Has your patient load substantially increased as a result?” She replied, “No but I just know it will.” (In an ironic twist, one of the top reasons I am called to consult in an office is decreased patient load.)

It seems to me that staff need to be as educated and informed on the program as the doctors because more than likely, the patients will approach the staff first. To transfer hysteria onto our patients before knowing all the basic facts is somewhat irresponsible, does not solve anything and mostly, is not helping the patient … our first duty.

The ACA likely is not the final iteration of public healthcare in our lifetime and I am pretty sure that once the fog lifts and the details become clearer, we will know better what we need and how we need to deal with it. In the meantime, the best advice is do not get left behind. Get on board. The ACA is here to stay so it is in your best interests to make it work for you and do what you can to minimize the confusion for your patients.

What You Can Do To Educate Yourself And Patients

1. Staff and doctors should attend seminars, and review the information together when returning to the office so they are both on the same page. In fact, it would be very worthwhile to develop scripting for patient questions to ensure consistent patient responses.

2. Do your research. Tap into the resources available through American Podiatric Medical Association (APMA), Codingline and your state associations. Also read articles that authors who have knowledge on the topic are kind enough to share.

3. Be a resource to your patients by having literature, Q&As and FYIs on podiatry services and informational links on your website where they can go for more information.

4. Ask questions of the experts and get answers. If a patient asks you a question and you are unsure of the answer, do not guess or give misleading opinions. You will only confuse the patient. Tell the patient you will look into it and get back to him or her.

5. Be transparent in your billing. Discuss fees and deductibles openly with your patients. Do not wait until patients receive a statement to explain uncovered services or products.

6. Reinforce your position as the service provider and suggest that patients need to take up specific benefit complaints with their insurance supplier.

7. Support the APMA’s Political Action Committee to advocate on behalf of the profession and be included along with the other specialties when developing new policy.

8. Do not try to beat the system. Stay ethical. Follow the rules. Don’t set yourself up for an audit.

I see and hear reaction to these changes from doctors and staff across the country. In general, all are challenged by the “new evolution” in healthcare and as a profession, we all face similar changes. Why is it then that some practices thrive in this environment and others struggle?

There is a French proverb that reads: “The more things change, the more they remain the same.” Translation? “Turbulent changes do not affect reality on a deeper level other than to cement the status quo.” Accept, adapt and move forward.