May 15, 2019

The Grand World of the AHCA

Healthcare reform is obviously a hot topic these days and for good cause. The Republican proposed reform, named the American Health Care Act of 2017, or the AHCA, has many pros and cons. The AHCA suggests a cut in Medicaid funding, as well as undoing the expansions to Medicaid that President Obama set forth in the Affordable Care Act, or the ACA. This topic is subject to much debate amongst the political powers.

Even with the expansions of funding implemented by the ACA, it is still a struggling program. While this may seem improbable, the truth is that while the ACA expanded funding, it did nothing to ensure that physicians and hospitals would necessarily accept the expansion. Even though such a large portion of the US population relies on Medicaid for healthcare coverage, the value of services reimbursement it provides to doctors and hospitals is considered stingy. It is why many healthcare facilities don’t accept its coverage. With every dollar allocated to Medicaid, only 20- 40 cents actually pay for medical coverage for the poor, which appears to be a major flaw in the system.

Here is a proposed solution to the problem: Higher reimbursement for healthcare providers. How will it help? With a little something called “Pay for Performance Reforms”. This means that Medicaid should be expanded, not scaled back, with the core component of higher payment being offered to providers ONLY when there is a positive outcome. There are many suggested ways to ensure that there is funding put in place to cover the costs of the expansions, but there is a united goal that must always be kept in mind: providing coverage for the vulnerable American children and adults.

Caretech is following these developments closely and will update our clients on anything that may affect their reimbursements and general course of business. Follow us on LinkedInFacebookTwitter and even Instagram for this and other important info!