Important Changes to Health Care Based on the ACA

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Important Changes to Health Care Based on the ACA

Eye Doctors — Are You Ready for the Affordable Care Act?

affordable care act

2014 is finally here, and with its arrival comes a few important changes to health care, based on the Affordable Care Act (ACA). The question is — are you and your practice ready for the changes? In this post, we break down a few key provisions of the ACA that will go into effect this calendar year. It’s time to get ready…

First, the more general things. Health insurance marketplaces are currently selling health insurance plans (as of Jan. 1, 2014) to people who did not formerly have insurance. This large group includes single payers, as well as small businesses who employ less than 100 people. What does this mean for eye doctors? In a word, expect more patients overall, with newly insured individuals coming into the marketplace, looking for care now that they’ve got health insurance.

Consider also the expansion of Medicaid that rolls out 2014, with a number of states expanding their individual programs to include all individuals who fall under 133 percent of the federal poverty line.Who will this coverage be extended to? Primarily to adults without kids who were not previously covered by Medicaid. Though states have the option to take part in this expansion, it will be funded by the federal government for three years or more, so chances are high. If you see a number of Medicaid patients already, many eye doctors can expect an increase in those patients.

Now onto more specifics. According to the American Optometric Association, “the pediatric vision benefit is one of the 10 essential benefits that create a basic benefits package for all health plans sold in the marketplaces, plus some plans outside of them.” The benefit includes an annual comprehensive eye exam, as well as a “materials benefit” for all patients under the age of eighteen years.

How might this development affect your practice? With just a brief glance at the numbers, it looks like a potential onslaught of millions of new patients who did not formerly have health and eye care coverage entering the market place. Catering your services via marketing efforts to these new potential patients may prove well worth the effort in the upcoming months.

[Photo Credit: NetDNA]

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