Health Reform Implications for Primary Care

 

 

 

 

 

by: Mark Ricketts, MD

 

As the Affordable Care Act implementation approaches, primary care physicians in the Birmingham area are becoming increasingly nervous. We are facing several unknowns, including income, access to the latest technologies and our ability to practice autonomously. All these concerns are well founded, because until this legislation actually begins to take shape, our medical community cannot predict how it will affect our practice.

 

Even with the element of uncertainty, there are several positive changes that will impact primary care physicians. Physicians and patients should be encouraged that pre-existing conditions will no longer be considered for insurance enrollment. This should motivate previously uninsured individuals to enroll, giving them an opportunity to receive treatment on longstanding conditions, and physicians will be given the opportunity to care for them.

 

The pool of patients will increase, likely resulting in more insured patients walking through the doors of primary care offices. Depending on the volume of patients an office currently sees, this can be viewed as positive or negative.

 

Another constructive implication is the coverage gap in Medicare Part D goes away. Financially strapped patients with high cost prescription drugs can continue to properly medicate and not deviate from a prescribed medication plan due to cost. The gap had previously forced some patients to under medicate, and there will be less incentive for this to continue under health care reform guidelines.

 

Our most challenging immediate hurdle for Affordable Healthcare is the implementation process. There are valid concerns around public awareness of the enrollment process. Details about the available plans are still scarce, and enrollment begins on October 1.

 

The months ahead of primary care physicians are filled with many unknowns. If we can get past the initial struggles of implementing a new process in our business, there is huge opportunity to provide better care for more people.

 

Dr. Mark Ricketts is a board-certified general internist with Brookwood Medical Center practicing in Vestavia Hills.