Although US Healthcare Sector too had to bear the backlash of the global economic upheaval in 2011, the year will be remembered for some bold and progressive healthcare reforms – Accountable Care Organization (ACO) Concept, expansion of Medicare reach, and an honest effort at fixing SGR dilemma being the prominent ones – promulgated by the Federal Government. Radical in nature, the reforms are seen as proactive measures to do away with long-standing issues, and keep all the vested interests happy – patients, physicians, health insurance providers, and the healthcare sector at large.
As the U.S. Department of Health & Human Services (HHS) turns over another year of eventful happenings, there is a feeling of accomplishment and great expectation emanating from the policy decisions made in 2011. As we infer the clues from the recently published annual report, discounting brand name prescriptions for seniors, helping prevent the nearly 2 million heart attacks and strokes every year, and a comprehensive effort to ensure a healthier America at a significantly optimized cost outlay stand out as the major accomplishments in retrospection.
Standing out as the leading healthcare reform, the Affordable Care Act’s reforms are seen as ensuring an affordable yet quality healthcare option for Medicare beneficiaries. Additionally, there has also been cap on the raising insurance premiums collected by the private insurance carriers. While more than 3 million seniors have stood to gain from 50% discount on brand name prescriptions, amounting to a substantial savings of 2 billion dollars for hitherto cash-crunch patients, small businesses could avail 35% tax credit for health insurance premium. Another, notable inclusion to have come out is the extension of parents’ health plan to young adults under the age of 26.
Following closely on the heels of Affordable Care Act’s reformatory changes is Partnership for Patients Concepts, which seeks to seamlessly integrate hospitals, insurance companies and other stakeholders to reduce healthcare-acquired infections and mistakes. Projected to save 60,000 lives over the next three years, the novel concepts envisages decreasing preventable hospital-acquired conditions by 40% in 2013, reducing hospital readmissions to 20%, and saving up to $35 billion across the system, including up to $10 billion in Medicare savings alone.
Last but not the least is the Healthcare Fraud Enforcement, which having already recovered $5.6 billion from fraudulent sources, projects even more stringent actions in the coming years. Specifically targeting Medicare related fraud, the HHS has issued directive to withhold payments on suspicious claims.
While these comprehensive measures are no doubt indispensable to optimizing healthcare overheads and expenditure, physicians’ task to get their bills reimbursed could get even tougher, thereby making sustenance and growth prospects equally competitive. Although they have had, by and large, a prosperous year revenue-wise, the ensuing financial year evokes an air of apprehension. But, amidst such gathering apprehension, they can still maintain sustainable, growth-oriented and competitive practices through strategic alliances with Medical Billing Companies, who have the credentials to offer turnaround advices for maneuvering through the ensuing spectrum of healthcare reforms.
Medicalbillersandcoders.com, with its long standing reputation of being a premier provider of Medical Billing and Operational Advisories, should be a preferential recourse to a majority of physicians across the U.S.