How to prepare for influx of newly insured patients

While many of the legislative changes affecting healthcare often take some time to trickle down to physician practices, many implications of the Patient Protection and Affordable Care Act matter to your business immediately, the foremost being how you will manage a potential influx of newly insured.

An estimated 32 million newly insured individuals are expected to flood the healthcare market when carrying insurance becomes mandated in 2014, but many payers have decided to already begin offering coverage to young adults up to age 26 through their parents' plans. As a result, there are two mantras emerging in practice management circles: "don't panic" and "don't wait."

"It may be one of those things where we won't be able to change the direction of the wind, but we do have the capacity to trim our sails," Judy Bee, a principal consultant in the California-based Practice Performance Group, told Medical Economics.

Adjustments practices are behooved to make include streamlining their operations, evaluating and possibly trimming their payer mix, spreading the load among nonphysician practitioners, assessing their collections policies and preparing to orient new patients to practice expectations, consultants say.

And this is where the "don't wait" part comes in: "There's no time like the present," Susanne Madden, president of The Verden Group, told Physicians Practice. "Even if you're not doing it because health reform is eminent, do it because you could probably stand to improve some things around your practice that can only save you money and help you provide better quality of care for your patients."

Fortunately, the view from the field looks encouraging, Kenneth T. Hertz, CMPE, a principal with the Medical Group Management Association's Health Care Consulting Group, tells FiercePracticeManagement. "Practices are really working on fine-tuning their current operations--process and flow through the practice, handling patients, processing charges and collections, follow up and more," he says. In addition, Hertz says he's seeing more practices looking to leverage technology, in part driven by HITECH as well as the need to provide better quality data going forward. To expand access, practices are not only looking into increased use of mid-levels, but also exploring the potential for telemedicine and closer relationships with "quick care" and retail clinics. "Folks are being creative," Hertz says, "but one of the foundational issues is to make sure that the current practice operates with maximum efficiency and effectiveness."

To learn more:
- read the cover article in the May 21 Medical Economics
- see this piece in Physicians Practice 

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