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    Obamacare rising costs creating challenges for physicians

    With President-Elect Donald Trump having campaigned vowing to repeal Obamacare, there are some who feel that the federal government’s announcement that premiums for midlevel health plans under the Affordable Care Act are expected to increase by an average of 25% in 2017 is nothing to worry about.


    Further reading: 10 things to know about HHS Secretary-designate Tom Price


    Still, until Trump does something—and he has wavered on the issue since the election and some in Washington don’t see the change coming as quickly as he claims—the increase is somewhat concerning and something that physicians need to keep an eye on.

    Pedram Salimpour, MD, believes what is happening is that the business of medicine is becoming corrosive to the practice of medicine.

    “What we want is to make seeing the doctor easier, but the current healthcare system is putting up barriers for healthcare consumers,” he says. “Higher out-of-pocket expenses and increased premiums mean healthcare consumers may be more likely to try to avoid doctors and hospitals, therefore, it is less likely they will receive proper preventive medical care, needed prescriptions or they may take less of a prescription to lengthen the time they are taking it.”

    And, as a result, when they finally see the doctor, they are usually sicker and it is costlier to give them proper treatment.

    Elaina George, MD, and author of “Big Medicine: The cost of corporate control and how doctors and patients working together can rebuild a better system,” says an increase in premiums will mean more challenges for independent private physicians to remain open.

    Mike Ducote, chief operating officer of CirraGroup, a healthcare financial technology company, says physicians may have a more difficult time in collecting payment, and this may increase the level of medical debt nationally. 

    “The trend that we have seen is that although patients could generally afford the premiums for healthcare, they had a very difficult time paying the out-of-pocket expenses, such as required annual deductibles,” he says. “With more of an individual’s income slated for premium payment, we can extrapolate that there may be less money available to pay for care that is not reimbursed by the high deductible plans.”


    Blog: Here's why a Trump presidency is good for physicians and patients


    It is important to note that while there will be governmental aid for premium payment for some patients, what has yet to be revealed is how extensive that aid will be.

    “Unfortunately, physicians and other healthcare practitioners have been feeling the squeeze of reduced reimbursement for quite some time now,” Ducote says. “I believe that is one of the chief drivers in the consolidation of many individual and small group practices, and I think we will continue to see consolidation as a method of increasing operational efficiency.”

    Combating the increase

    Sasha Noe, DO, Ph.D., a board-certified family physician with the Apollo Beach Family Medical Center in Apollo, Florida, says her practice will likely see a decrease in patient visits from patients with ACA plans because of the premium increases.

    Next: “One of the things that I am doing to combat the problem"

    Keith Loria
    Keith Loria is a contributing writer to Medical Economics.

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    • UBM User
      I would like to know who is getting away with only a 25% increase as my increase is about 60%. I am not alone in this, most of my friends are experiencing similar increases. It went from $770 to $1225 and the deductible increased from $12,000 to $13,000. So basically, I pay for the first $25,000 (yearly premiums plus deductible) before insurance pays a cent (except for preventive care services). How is this affordable care?

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