Bundled Medicare Patients for Obamacare

Bundled Medicare Patients for Obamacare

Obamacare seeks to reduce medical costs by 700 billion between 2013 and 2022. One of the ways the federal government plans to do that is through bundled Medicare payments.

ObamacareThe system removes the fee for service model and replaces it with a bundled plan for inpatient hospital stays and post discharge services.

Clinicians who don’t participate in bundled payment options will lose patients and revenues to competitors who do.

Bundling For Savings

One-fifth of the funding for Obamacare comes through savings obtained by reducing Medicare reimbursements, reducing the length of hospital stays and readmission rates, and bundling payments.

There’s also a push for in-home care to reduce expenses.

The Bundled Payment for Care Improvement Initiative was launched on Jan. 31, 2013 to grade the financial and treatment performance for patient care episodes utilizing a team care model.

With bundled payments, a team of healthcare professionals oversee a patient’s care and a dollar amount for reimbursement is assigned. The team is responsible for providing the patient with needed treatment, while remaining within the monetary target.

Teams are rewarded financially for accomplishing their goals. Clinicians that don’t choose to participate will lose the most as fees are cut.

Working With IPAB

The Independent Payment Advisory Board (IPAB) is a 15-member panel appointed by the president and charged with the task of finding ways to reduce medical costs. Any recommendations made by the board automatically become law unless Congress chooses to overrule.

The board is a more powerful version of the Medicare Payment Advisory Commission.

There’s a big push by Obamacare to identify and evaluate treatment methods that are efficient and cost-effective. One of those techniques is by providing in-home care that employs technology to monitor a patient’s state of health in the home instead of at a hospital or care facility.

Depending on the type of monitoring being conducted, readings could be transmitted to a practitioner’s office electronically or could include home visits by a healthcare professional.

ObamacareThe bundled care initiative was designed to reduce costs among Medicare patients.

Unfortunately, it will also limit reimbursement revenues for clinicians who choose to offer independent care at their practice and not participate in a physician team for bundled care.

As the pressure to reduce costs associated with Medicare patients continues to increase, many medical professionals will find their choices are limited.

There are options, but all are untenable for those in private practice.

Clinicians can choose not to join a healthcare team, lose patients to competitors who are part of a team, become resigned to a reduction in Medicare payments, accept bundled payments and reduced revenues, or stop seeing Medicare patients at all. The choices clinicians make will have a dramatic and long lasting impact on their patients and practice.

Obamacare Changes the Healthcare Landscape for Retirees

Obamacare Changes the Healthcare Landscape for Retirees

Much has been said in the media about the changes in store for seniors under the Affordable Health Care Act, known as Obamacare.

The legislation appropriates a significant portion of Medicare money to fund Obamacare, limits contributions to flexible spending accounts (FSAs), and increases taxes on unearned income. Some of the new taxes only affect top earners, but the law is also worrying for those with retiree healthcare plans.

ObamacareThe End Of Retiree Coverage?

General Electric, IBM and Time Warner are just some of the major corporations that have announced the end to generous retiree insurance coverage.

All three companies indicated that instead of purchasing healthcare policies for retirees, they will begin giving them a yearly stipend to spend on coverage through the Healthcare Insurance Marketplace or private policies.

Many employers are choosing to the fines levied by Obamacare rather than offer insurance for employees or retirees.

Doing so is less expensive than buying insurance for a company’s bottom line and reduces overall expenditures.

If stipends are less than actual costs, retirees will be responsible for making up the difference.

A Return To Pre-World War II Practices

A freeze on government wages during World War II spurred employers to offer healthcare as a means of retaining workers and it became common practice.

With the launch of Obamacare, many companies are choosing to eliminate the employer-based plans of current workers and those who have retired.

According to a study released by the Kaiser Family Foundation, the number of companies offering healthcare benefits began to drop before Obamacare was passed.

The study indicated employer-offered coverage fell from 66 percent over the past 10 years to a current level of 57 percent.

Overworked Healthcare

Business owners have cited an overuse of benefits as a key element that’s driving the transition.

ObamacareCompany officials say with the generous benefits they offer, workers and retirees are seeking clinician care and an array of expensive tests that are unnecessary, resulting in higher costs.

Many businesses offered healthcare coverage as a bonus to retirees for being faithful employees.

Today’s employers say skyrocketing costs has made healthcare a costly burden that places them at a major disadvantage in a global economy.

Obamacare is changing the way employee and retiree healthcare has been delivered over the past 75 years, leading many seniors to wonder how their healthcare needs will be financed and managed after their retirement.

Obamacare and the Investment Income Tax

Obamacare and the Investment Income Tax

There are many ways that have been structured into the Affordable Health Care Act (Obamacare) to fund the legislation. One of those methods is the investment income tax (unearned income). Wealthy individuals will pay a 3.8 percent surcharge on capital gains and dividends.

ObamacareThe tax went into effect in 2013 for many, but some may have avoided the initial financial pain due to the economic climate and losses.

Who Is Subject to the Tax?

The tax represents a 3.8 percent increase on the already existing tax and affects individuals with an adjusted gross income of $200,000 or more and $250,000 for couples filing jointly.

The tax increase affects a comprehensive range of stocks, bonds, commodities, trusts, annuities and specialized derivatives.

The increase also affects royalties, rentals, self-employment income, and home sales for people who have owned the property for more than five years.

Accounting firms have been hard at work searching for ways their clients can avoid a major jump in their taxes.

Many taxpayers haven’t seen an appreciable difference yet due to an array of economic factors and personal considerations, but will through a combination of the investment tax and mandatory insurance requirements.

The Internal Revenue Service can begin withholding funds through the Individual Mandate Tax on those who have failed to purchase healthcare insurance.

A charge of $95, or 1 percent, whichever is greater, will be levied on anyone without healthcare insurance and the tax increases depending upon how many uninsured individuals are in the household.

The tax increases through 2016 to top out at 2.5 percent or $695. The IRS can withhold the amount from any refund taxpayers might have coming, but can’t garnish wages or present taxpayers with a bill for the amount.

The Changes That Will Affect Taxes

Understanding the tax or seeking the assistance of an account is particularly important for those who fall near, but below the $200,000-$250,000 and suddenly come into a substantial amount of money.

Selling a second home, an increase in come or a bonus could quickly land individuals in the position of paying additional taxes.

ObamacareChanges in family size can also affect their portion of taxes. 

Those who qualify for a federal subsidy to purchase insurance and experience an increase in income would have to pay back the subsidy.

The good news is that virtually everyone can now deduct up to 10 percent of their medical expenses People can still utilize a flexible spending account (FSA) to save on medical costs, Social Security, Medicare and income taxes, though they’re limited to a $2,500 personal contribution.

The investment income tax increases the rate from 15 percent to 18.8 percent on unearned income and is expected to affect only the wealthiest 2 percent of Americans. Money raised through the tax will be placed in federal coffers to help fund Obamacare.

The bottom line is that taxpayers who earn more than $200,000-$250,000, have unearned income or spend a significant amount on healthcare will see their taxes increase.

Obamacare and the Medical Device Tax

Obamacare and the Medical Device Tax

Known as Obamacare, the Affordable Health Care Act places a tax on a variety of services, items and businesses. The Medical Device Tax has come under fire from a variety of companies and individuals who claim it will accomplish everything from the loss of jobs to the stagnation of innovation, and take away medical devices from the elderly and infirm.

ObamacareThe truth is somewhere in the middle.

Obamacare does place a tax on medical devices, but the tax is levied against companies that make them, not against the people that use them.

The 2.3 percent excise tax is on the sale of the devices, not profits, and was actually cut in half from an original figure of 4.6. The tax went into effect on Jan. 1, 2013.

Who Pays the Tax And Why?

The tax affects devices that include defibrillators, dialysis machines, heart monitors and pacemakers. Fearing outsourcing of production and a loss of potential revenue, the Act covers all device manufacturers, regardless of where the equipment is actually made.

The law is only supposed to apply to devices that require the approval of, or referral by, a physician.

Those include many high-dollar tests conducted with MRIs, lasers and similar equipment.

Selling Devices Over-The-Counter

The Act says devices sold over-the-counter directly to consumers are exempt. Those devices include common items like contact lenses, eyeglasses and hearing aids.

Even though some devices can be sold directly to consumers, such as blood pressure and glucose monitors, many insurance companies won’t cover the cost unless it’s accompanied by a doctor’s prescription.  

Patients would have to pay for the equipment out of their own pocket and the cost wouldn’t count toward the individual’s deductible.

Obamacare’s device tax may not be applied when patients purchase any of the devices, but individuals will most likely experience overall increases on retail prices.

In medical facilities, patients will be billed more to use the machines.

Insurance companies may or may not pay the increased costs, but will most likely pass it on to patients in the form of deductibles.

Efforts to Repeal The Tax

Many in the House have voiced their intent to repeal the tax.

ObamacareThey cited the law as economically harmful, with the potential for a loss of life if device manufacturers reduced production or if medical facilities refused to purchase devices due to cost increases.

House officials claim the tax would stifle research and development, and would adversely affect start-up companies that might not be able to afford another tax as the cost of doing business.

Confusion surrounds many of the Obamacare taxes and many individuals were highly concerned that they would be denied medical devices they count on through the inability to afford another tax.

Only the makers of medical equipment will be forced to pay taxes on their products, but patients will likely experience the tax through higher retail prices, increased costs to use the equipment in medical facilities, and fewer referrals to obtain tests using high-dollar equipment.

The Impact of Obamacare on Medicare and Medicaid Patients

The Impact of Obamacare on Medicare and Medicaid Patients

Obamacare is changing Medicare and Medicaid in many ways. Some are good for patients, but not for practitioners. One of the main objectives of Obamacare is to reduce healthcare expenses.

ObamacareThe economic reality for some patients is healthcare where none existed before, while others will see more out-of-pocket expenses.

Obamacare taps Medicare funds heavily to support the legislation, while reducing reimbursement amounts to clinicians.

Becoming more efficient in treating patients and office processes is critical and there are cost effective software programs that will increase efficiency and save money.

Software programs like In Touch EMR and In Touch Biller PRO have tools to automate and accelerate marketing, documentation, billing and reimbursements.

Clinical Contact and Therapy Newsletter software provides practitioners with done-for-you solutions to increase referrals and retain established patients.

Medicare Ups And Downs

Obamacare is closing the donut hole in Medicare for prescription drugs and reduced the cost of many medications. Patients can now obtain a lot of free wellness services, screenings, tests and vaccines.

Patients with Medicare Advantage programs will see increases in their co-pays, deductibles or both. Obamacare reduces expenses by reducing payments.

Medicare won’t go away, but patents will wake up to the reality of higher costs and fewer practitioners willing to treat them.

Expanded Medicaid

Under Obamacare, states that agree to do so will expand Medicaid eligibility requirements. That means people making $15,800 in 2013 will be able to get Medicaid.

However, states don’t have to participate in the program, which could lead to a substantial number of people still without coverage.

The Congressional Budget Office estimates that 12 million new patients will be added by 2015. That’s a lot of additional patients and the problem is that in 2011, one out of four clinicians refused to take Medicaid patients.

Finding a practitioner that accepts Medicaid is already a problem.

Now there will be more patients competing for fewer practitioners, along with overcrowding in hospitals and practices that do take Medicaid. Many clinicians have said they’re going to close their practices or refuse to treat those on Medicaid and Medicare due to reduced reimbursements, and no one wants that.

Making Opportunities

This is an opportunity for clinicians to ask themselves what they can do to be part of the solution instead of the problem. More patients and less reimbursement provide an incentive to get patients well faster, which is another goal of Obamacare.

Clinicians can present patients with programs that will help them get better quicker and save them money.

ObamacareFor example, consider group wellness and preventative programs.

Charging patients $30 per session incurs less cost for patients, while increasing the number of individuals that can be treated at one time.

Be creative in identifying opportunities that benefit the practice that also provides an environment that’s financially appealing to patients.

Clinicians must be aware of the changes in the Obamacare economy and be prepared for them with alternatives that generate more referrals and retain established patients.

How to Thrive in the Obamacare Economy with Systems and People

How to Thrive in the Obamacare Economy with Systems and People

The primary objectives of Obamacare are to reduce expenses while making more money. The law does that through penalties, fines and taxes in the form of the Individual Mandate Tax, fines for not having healthcare insurance and reducing Medicare reimbursements.

ICD 10 codesTo survive in the Obamacare economy, clinicians must become more efficient with the people and systems in their practice.

The Human Element

Practitioners will have to be more efficient in identifying, hiring and motivating the people in their practice.

Identifying the right people is critical.

Clinicians can’t afford to have people who just do the minimum for a paycheck.

Practitioners should be looking for people who go above and beyond.

If a staff member has extra time between patients, the desirable person is one who will use that time to conduct some marketing, work on a piece for the practice’s newsletter or some other task to benefit the practice.

When practitioners identify staff members who won’t expend extra effort to benefit the practice or are unwilling to change to meet the clinic’s demands, they may have to be dismissed.

Hiring new people is time consuming, but clinicians must do what’s best for their practice. One negative influence will spread. Don’t accept substandard attitudes.

Patients are paying more out-of-pocket expenses and they’re going to become even more aware of where they go for healthcare instead of simply going where their insurance company sends them.

The quality of the people in the practice will define it and make it stand out above competitors. Customer service and marketing has never been more important than in the Obamacare economy.

Automate The Systems

There are numerous systems that will increase a practice’s efficiency, increase referrals, provide marketing tools and expedite billing.

The key concept for these systems is automatic.

The patent-pending In Touch EMR provides practitioners with an automated insurance verification system, patient workflow, and a streamlined documentation system.

In Touch Biller Pro offers integrated scheduling, documentation, billing and marketing in a single product to increase productivity and revenues.

The automated software system can be integrated with the In Touch EMR and is Medicare compliant.

It can be used with PCs, Macs and Android systems, along with iPads. It offers claims scrubbing, batching and denial management for top efficiency.

Clinicians can also take advantage of automatic newsletter generators, done-for-you referral services, coaching and marketing solutions.

Available systems run the gamut, from Therapy Newsletter to Clinical Contact, all of which are specially designed to automate processes, increase efficiency and market practices effectively.ICD 10 codes

Good people with bad systems are a recipe for disaster. Good systems in the hands of the wrong people are potentially worse.

Clinicians may find that certain staff members have turned into prima donnas who don’t or won’t learn new things or are unwilling to change.

It’s critical to have the right people in the right positions, no matter what steps must be taken to accomplish that.

Clinicians must be strong leaders who inspire and motivate staff, while employing systems that streamline office and patient processes to survive in the Obamacare economy.