ObamaCare: What do Physicians Need to Know?

Posted by Team PracticeForces on Nov 10 2014

Learn how ObamaCare is slated to affect your private practice, and stay ahead of the influential curve.PracticeForces CEO, Kunal Jain, hosted a healthcare panel for hundreds of independent physicians and small practices in the Tampa Bay area.

During the panel, Jain discussed with the top area doctors on topics such as ObamaCare, Medicare HMOs, HIPAA compliance and the role of private practice.

Dr. Jawahar Taunk, MD, Gastroenterologist:

ObamaCare has become a popular care and we all have to deal with it. There is a lot of fear about it, but as far as physicians are concerned, I think if you look in a broad sense they are benefiting from it.

If you are a primary care physician and you are providing service, you get a 10% Medicare benefit. If you are a surgeon providing care in a rural area, you can capture 10% Medicare bonus. If you are a primary care provider taking care of Medicaid patient, again, your payments will be no different than any other Medicare patient; it is also reducing your paperwork.

A lot of physicians will say that paperwork will increase with any enforcement, but this act reduces your paperwork. It standardizes your billing, so once billing is standardized, all insurance companies have to use that, and the queries will be less. Even if there are queries, rather than sending paperwork to the physician, they can electronically communicate with the provider; that will reduce the paperwork for physicians.

It is also addressing the issue of physician shortage, and thereby it will create job opportunities for physicians. If you are a medical student and you decide to go into primary care, you will get a scholarship. If you are graduating as primary care and want to go in a rural area, and serve rural areas, your loan repayment would be subsidized and you will get tax incentive. I, personally, for physicians and especially primary care physicians, think they are all benefits.

Dr. Rajan Naik, MD, JSA Healthcare:

I just attended fundraising for Bill Nelson; this is the first time in life I paid Democrat. He was very open, and is a very smart guy, but I’m comparing him to like a “Robin Hood.” He steals money from the rich and give to poor, nothing wrong. The whole idea of the Affordable Care Act is take away money and give to poor people in this country, so in next few years, one half of the population in America will be under Medicaid.

They want to be like Canada eventually, unless I sign checks to the Republican Party and they come back; otherwise, we are stuck with this. There is something good about the ACA; being from India we have sympathy for poor people, so it is good, and lots of patients get insurance.

You must have read the newspaper… My company, which I sold to JSA, got a maximum contract. We cannot see those patients, but everyday we are seeing 15 to 20 new patients. We do not have time to see patients, so we said “enough is enough,” because all these patients join the Affordable Care Act and ObamaCare, or join Humana, whatever it is. It is good for the patient, but for physicians, it is not good for the long-term.

The other thing about ACA, which I think some of the people know I work with, are Medicare Advantage Plans called HMOs. The first thing they decide is to cut down the funding on the HMOs; what happens is, for people like me who work with a lot of Medicare HMO patients, our funding and earnings are down. We will live with it, but at the same time ACA has some good points and bad points, and it is all politics.

Radha Bachman, ESQ, Shareholder at Carlton Fields Jordan Burt:

Obviously the good thing about the ACA is that I think everyone can agree, as a society, that it makes sense that we have more individuals who are covered by insurance, and not burdened with the financial strain of having to come out-of-pocket to provide their most basic health care needs.

I think, from that perspective, we would all agree that the concept of ACA and the reasons behind adopting it in general are good. However, the problem is that it has caused and continues to cause so much uncertainty in the profession, certainly with respect to physicians. I can tell you, from personal experience with a larger provider as well as with hospitals and health systems, and larger group practices that are trying to figure out where they fit into the whole grand scheme of the healthcare spectrum, that I think that uncertainty leads to negative consequences at the end of the day.

You have physicians that are coming out of residencies, who are so inhibited by the concept of the Affordable Care Act and what that means for them, that they decide to pursue hospital employment, as opposed to being an entrepreneur and saying, “I want to open my own practice, I am willing to take the risk.”

I talk with residents all the time, and they are just not willing to do it. I think that is a detriment to our society. At the end of the day, I think that the intentions were good, and continue to be good, but it is going to take some time to give people the confidence to return to an entrepreneurial way of life, and in healthcare especially, you know with respect to direct providers and physicians.

Sidd Pagidipati, Co-Founder of Physicial Partners:

I want to do a quick poll. How many of you guys like ObamaCare? Raise your hand. How many of you guys do not like it, raise your hand? How many of you are indifferent? It looks there are more people that dislike it.

When it was about to be passed, my father, a physician, and I were arguing, and he said ObamaCare is a disaster. You know, it is going to cut funding for Freedom Health and all these taxes. He said, “Sidd can you do anything about it?” I said, “No, no I cannot do anything about it.” He said, “You are going to have to have lobbyists change the law.” I said, “no,” and he then told me, when these laws pass, “you have an incredible opportunity, because lobbyists are writing these laws, and some are going to win and some are going to lose. What you have to do is understand what is in that law and take advantage of it.”

So, when we started Freedom Health, we started it right after the 2003 Medicare Modernization Act, which put a lot of funding into the Medicare HMOs. In 2005, Part B passed, which increased a lot more government funding into the drug program.

One of our colleagues started a company called Member Health; he built that into a $500,000,000 PDP (Prescription Drug Plan) company in 18 months. In 2010, we invested in a consumer driven HMO in New York City called Oscar. Those guys have just raised $190,000,000, and a billion dollar evaluation two years after I started. From your perspective, we heard the patient position, but from ours, there is a huge opportunity. Yes, there are going to winners, and yes, there are going to be losers, but the law is the law/

Dr. Chandresh Saraiya, MD, Co-Founder of Florida Medical Clinic:

I think there are excellent responses, so I would just say maybe couple of things.

  • Talking about it can be very political, but the important thing here is it is not going to go away and we have to deal with it.
  • The second thing: two things that I like are increasing coverage, and the fact that it is addressing efficiency in the health care system. You know, there is so much inefficiency in the health care system, and a lot of things have been done in past; nothing has worked, yet this act is already beginning to work and is going to work to try and improve efficiency in healthcare.
  • The third thing that I will say is from the point of view of physicians. As you know, previous comments were made that I think the focus is going to be on value-based providers. Value is defined as quality upon cost; so, providers who are high in quality and lower in cost would be the ones in demand 

If you are a solo practitioner, do not fear: the worst thing you can do is to run and go to the hospital and join a hospital. There are opportunities for solo practitioners, people in smaller groups and people in bigger groups, to try and become efficient by looking upon their own practice, to see what they can do to deliver their care more comprehensively and efficiently to patients. By learning how to get better outcomes and lower the total cost of care, you will become darlings of the pairs and CMS.



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Topics: ObamaCare,, primary care physician, physician news,

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