Physician Survey: ACA Will Increase Costs, Reduce Access
By Dr. James Palermo // December 7, 2013


NEARLY HALF BELIEVE OBAMACARE WILL CUT SHORT THEIR CAREER

There's little debate about a growing primary care physician (PCP) workforce shortage in the United States, and the need to bolster the supply of practitioners to provide adequate access to needed primary care services for the "baby boomers" as they age, and the more than 30 million U.S. residents expected to gain health coverage through the Affordable Care Act (ACA, aka Obamacare) beginning in 2014.

But what about the existing physician workforce? What impact do today's practicing physicians think the ACA will have on the care of their patients, their practices and their professional futures?

ALMOST 50% OF PHYSICIANS SAY ACA MAY CURTAIL THEIR CAREERS

According to a recent national survey by Jackson & Coker, a highly respected physician staffing firm, nearly half of the 3,072 practicing physician respondents in a variety of specialties believe the ACA will somehow impact their career timelines by either leaving practice earlier than they planned or in some cases, leaving it as soon as possible. This introspective re-evaluation of practice plans and length of stay in practice by established physicians adds to the uncertainty of the effectiveness and success of the ACA.

Doctors
In a recent national survey, nearly half of the 3,072 practicing physician respondents believe the ACA will somehow impact their career timelines by either leaving practice earlier than they planned or in some cases, leaving it as soon as possible.

Of the survey respondents, 24 percent practice in internal medicine subspecialties and 10 percent are primary care/generalists. When asked how the implementation of the ACA will affect their career time lines, 30 percent of respondents said they will leave the practice of medicine as soon as it is feasible for them to do so, and 19 percent said they will practice medicine for a shorter period of time than they originally anticipated. 31% said they do not anticipate making any changes to their career timeline and 15% remain unsure.

REDUCED COMPENSATION UNDER ACA MAJOR CONCERN

With an estimated 16 million new Medicaid enrollees and many insurance companies reducing physician payments in order to keep premiums lower on the ACA health insurance exchange, compensation is a major concern for physicians as Obamacare rolls out.

In the Jackson & Coker survey, 71 percent of physicians said they believe the ACA will negatively impact their compensation.

Fourty four percent of physicians polled said that they they would not participate in the Obamacare health insurance exchange, and 56 percent support repealing or defunding the law.

MEDICAID PHYSICIAN ACCESS ANOTHER MAJOR ACA OBSTACLE

With Medicaid Obamacare enrollees far outnumbering those who have enrolled and procured policies in the health exchange marketplace, there will be an increasing demand for physicians to accept new Medicaid patients into their practices.

Many physicians are concerned that they'll be paid less - often a lot less - to care for the millions of patients who are projected to buy coverage through the health law's new insurance marketplaces.
Many physicians are concerned that they'll be paid a lot less to care for the millions of new Medicaid enrollees and patients who are projected to buy coverage through the ACA's new insurance marketplaces.

However, partly because Medicaid compensation is significantly lower than other third party payers, including Medicare, and partly because the administrative burden placed on physician practices by Medicaid is often overwhelming, many physicians do not accept new Medicaid patients.

The issue of finding enough primary care and specialty physicians to actually meet the needs of existing and now new Medicaid enrollees may, in fact, prove to be an even more egregious obstacle to the success of Obamacare than the many challenges already plaguing it since October 1.

SURVEY FINDINGS: MAJORITY OF PHYSICIANS GENERALLY NOT SUPPORTIVE OF ACA

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The majority of physicians polled are generally not supportive of the ACA.

Here are other key findings of the Jackson & Coker survey:
.For patients with health insurance, 80 percent of physicians said they believe those patients will wind up paying higher healthcare costs under the ACA
.Seventy-six percent of physicians said overall healthcare costs would go up due to the new health reform law
.Seventy-three percent of physicians said patients would have less choice in picking their doctor due to Obamacare
.Sixty-six percent of the physicians said they would have to spend more time on administrative duties because of the new law
.Sixty-one percent of physicians said their opinion of the law has changed for the worse
.Sixty percent of physicians said the quality of patient care would be negatively impacted
.When asked how the law would impact their treatment decisions for patients, 57 percent of physicians said the law would have a negative impact


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