It’s now been over four years since the Affordable Care Act, otherwise known as “Obamacare”, officially went into effect in the United States. However, we are just now learning the wide-ranging impacts the legislation has had on the healthcare industry, and in particular on medical billing in hospitals and doctor’s offices throughout the country. While we still don’t know the scope of changes that are yet to occur, there are some undeniable trends that seem to be making their way down the pipeline, particularly as we prepare for the oft-mentioned “employee mandate”, which, if all goes according to the (often revised) plan, goes into effect in 2015.
Medical Billing Will Increasingly Become Outsourced
Medical billing has never been a particularly popular activity in doctor’s offices and in hospitals. Now, with the increasing number of medical coding requirements resulting from the Affordable Care Act, medical professionals are continuing the trend of outsourcing this work to companies that specialize in it. According to a report in Seeking Alpha, large outsourcing companies such as Firstsource Solutions and WNS are increasing their domestic US presence to accommodate a growing number of medical professionals who are choosing to outsource medical billing to them.
By 2015, more doctors and hospitals are projected to outsource their medical billing than ever before, in large part thanks to Obamacare and growing administrative costs. The other less discussed (but no less important) consideration is that outsourcing medical billing reduces liability on the hospital or doctor’s office.
The Number of Medical Billing Professionals Will Grow Dramatically
While outsourcing is certain to increase in 2015, The Bureau of Labor Statistics estimates that the medical billing industry as a whole will increase in 2015 as well. In fact, it is estimated that the industry will grow by about 22% between 2012 and 2022. While some of this increase is in fact due to regulatory and administrative burdens resulting from the Affordable Care Act, many experts also believe that the changes from the ACA will actually reduce administrative issues, increase efficiency, and ultimately grow the medical billing industry at a slower rate than it otherwise would have in the absence of the Affordable Care Act.
The other key reason why the medical billing profession is expected to grow is the simple fact that, under the Affordable Care Act, more people will have access to healthcare, which means more medical coding and medical billing will be required. While increased access to healthcare for the overall population (and particularly the poor) is a worthy goal, it comes at the very real cost of increased administrative and regulatory issues, at least in the short-term.
Precertification and Eligibility Verification Will Continue to be Cumbersome
While it’s true that one of the original promises of the Affordable Care Act was reduced difficulty for hospitals and doctor’s offices that needed to pre-certify or verify eligibility of a patient for a particular procedure, reality has proven itself to be more complicated. Early reports indicate that, at best, this process is as slow and cumbersome as it has always been, while critics claim that it is in fact less efficient than before the ACA was passed into law. Part of the problem stems from the fact that many insurance companies and medical offices still aren’t even sure how to properly code procedures and medical services; a problem that, while severe, should hopefully improve gradually in 2015 and onward if all goes well.
Obamacare is causing significant changes in the medical billing industry. Hopefully the negative aspects will diminish over time, while the promised benefits of the law start to take hold.