From disallowing insurers to reject coverage for those who have preexisting conditions to making sure that healthcare companies pay for preventative care, the Affordable Care Act commonly called Obamacare has inspired a number of changes including modifications to healthcare administration. If you’re interested in obtaining a degree in healthcare, be sure to review the changes put in place under the new law. Obamacare has changed healthcare administration by:
• Implementing premium rebates for under-spending
• Supporting team-based treatments
• Establishing a preventative care incentive
• Standardizing disclosure forms
• Causing a rise in outsourcing for medical billing
According to the healthcare law, insurers must spend at least 80 percent of each member’s premium on his or her medical care. Insurance companies can also use premiums to improve the quality of care. For those who are employed by large companies, insurers must spend 85 percent. When insurance companies overspend on administrative costs, salaries or bonuses, they are required to send their members a premium rebate. A report from 2012 confirms that the new law resulted in 12.8 million businesses and individuals receiving more than $1.1 billion back in premium rebates.
Team-Based Healthcare Treatments
To encourage healthcare facilities to provide a higher level of care, Obamacare is promoting team-based patient treatments. This form of healthcare frequently results in better patient outcomes, and it can decrease insurance costs. Often, team-based care requires a facility’s administrative staff to follow up with patients by contacting them with instructions for taking medications and scheduling additional appointments. When the administrative staff takes on these tasks, the facility’s doctors can spend more time with each patient to provide specialized care that involves a proper diagnosis as well as developing an effective treatment plan. Team-based care also consists of doctors working together.
Related Resource: Top 10 Best Online MBA in Healthcare Management Degree Programs
Preventative Care Incentives
To incentivize patients to seek preventative care, healthcare providers are changing the way that they bill for services. More providers are adopting bundled payment programs, which require one fee for treatments that necessitate multiple visits. Flat fees are another popular choice. Providers are implementing different payment options because Obamacare has increased the importance of low cost quality care as well as established pay-for-care metrics. These modifications show that the healthcare industry is finally seeing the benefits of promoting preventative care. Also, since people are using preventative care more, approximately 76 million people are scheduling wellness visits. This is increasing the industry’s need for administrators.
Establishing Standard Forms
Insurers must now use standardized forms to summarize each member’s coverage and benefits. This includes information regarding deductibles, out-of-pocket limitations and co-payments. All insurance companies are required to detail the services that they exclude within one particular section of the form. Obamacare further compels insurers to calculate and reveal a person’s typical out-of-pocket expenses for two medical situations, which are how much it costs to give birth and the expense of treating type 2 diabetes. Later forms will feature additional cost disclosures for other types of medical treatments. This information makes it easier for members to budget their costs and confirm that their healthcare provider is charging them properly.
Outsourcing for Medical Billing
Because Obamacare requires additional coding, medical providers are beginning to outsource the task. Several large outsourcing companies are expanding their operations to accommodate the change. According to projections, more doctors and hospitals are predicted to send their medical billing reports to specialized companies for processing than ever before. One outsourcing benefit is that it decreases a provider’s liability. Outsourcing also makes administrative work more efficient. The medical billing field is expected to grow from the implementation of Obamacare since more people will have access to healthcare. This fact is likely to increase administrative costs for medical providers and insurance companies.
Policymakers crafted Obamacare to help people obtain affordable health insurance. To make health insurance companies and providers more accountable and efficient, Obamacare enacted administrative changes. If you’re interested in a healthcare career, you’ll be working under these new laws and protections.