Obamacare Has Given Doctors A 3% Pay Raise

October 15, 2015 - Primary care physicians got a 3% increase in reimbursement last year thanks largely to expansion of health benefits under the Affordable Care Act, a new analysis indicates.

Primary care doctors, including internists, family physicians and pediatricians, saw their "reimbursement collections" rise 3.3% from 2013 to 2014 in states that didn't expand Medicaid, according to a project of the Robert Wood Johnson Foundation. In states that expanded Medicaid under the health law, the increase was 3%.

"Reimbursements are up a bit so physicians are doing ok," Kathy Hempstead who directs the Robert Wood Johnson Foundation's work on health coverage issues said in an interview of the analysis, which draws from a database of nearly 20,000 doctors. The database is part of the ACAView project, a joint effort between the foundation and Athenahealth (ATHN).

The reimbursement increase came from an average of all payers, including Medicaid, Medicare coverage for the elderly and private insurance. The health law began to offer broader coverage in 2014 when uninsured Americans could begin shopping for subsidized private coverage on government-run exchanges.

The across-the-board increase in reimbursement to doctors is contrary to worries some physicians had about payments from a new government program.

"The world didn't explode," Hempstead said. "Life has gone on." 

The health law has expanded health coverage to millions of Americans largely via subsidized private coverage offered on government-run exchanges by private carriers such as Aetna AET -0.91% (AET), Anthem WLP +% (ANTM), Cigna CI +0.00% (CI), Humana HUM +0.00% (HUM), UnitedHealth Group UNH -3.39% (UNH) and the nation's Blue Cross and Blue Shield plans. Another 30 states opted to take advantage of the health law's federal funding to expand their state Medicaid programs.

To be sure, doctors have largely done well even though the foundation's analysis shows patient visits to physician offices has been flat. Doctors, however, appear to be making up any lost revenue on volume by treating patients with more complex medical conditions.

Under new models of care such as patient-centered medical homes and accountable care organizations, industry analysts say it would make since for primary care doctors to be seeing more complex cases. In these models, it's common for primary care doctors to work as a quarterback of sorts in a team-based approach to medical treatment.

"(Primary care physicians) are taking on more care coordination roles under team-based delivery models promoted by the ACA and are shifting many patient visits to physician assistants, nurse practitioners and other providers," said Travis Singleton, senior vice president of MerrittHawkins, one of the nation's largest physician recruitment and staffing firms. "Primary care physicians are focusing on more complex cases, for which they are paid more on a relative value scale. This allows for primary care visits to be flat while reimbursements rise."

By: Bruce Japsen
Posted on Forbes.com

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