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How Reform Affects Your Doctor and Hospital:

Influx of New Patients

As the pool of insured people grows, more Americans will be looking for care, particularly from a primary care doctor. Both physicians and hospitals are likely to experience an increase in patient load.

Image of Doctors and a Hospital graphic.

More Medicaid Patients

Doctors may be getting more patients since the new law changes the eligibility requirements to get into the program.

Taxes on Medical Devices

In 2013, the law establishes a 2.3% sales tax on the sale of a medical device by a manufacturer or importer. Exempted from the tax are eyeglasses, contact lenses, hearing aids, and a number of other devices.

Changes in Medicare and Medicaid Reimbursement Rates

Doctors will experience a number of changes over the next four years in Medicare and Medicaid reimbursement rates. In 2011, for example, primary care physicians and general surgeons received a 10% Medicare bonus payment. On the other hand, 2011 Medicare Advantage payment benchmarks were frozen at 2010 levels, and these benchmark reductions will continue in subsequent years.

Access to Training and Higher Reimbursement Rates for Primary Care Physicians

In 2011, doctors were encouraged to work in underserved areas through expanded funding for scholarships and loan repayments for primary care practitioners. The law also provides increased Medicare reimbursement for primary care physicians and general surgeons, as well as increased training support for primary care physicians.

New Reporting Requirements for Doctors and Hospitals

Doctors will have to adopt new methods of reporting, as the law establishes various new requirements, including quality measure reporting programs.

Incentives for Better Patient Outcomes

  • The law provided for the establishment of a new, private, nonprofit Patient-centered Outcomes Research Institute in 2010.
  • In 2012, the law provided new payment incentives for enhanced quality outcomes for acute care hospitals.
  • The law also directs the Centers for Medicare and Medicaid Services (CMS) to track hospital re-admission rates for certain high-volume or high-cost conditions and uses new financial incentives to encourage hospitals to reduce preventable re-admissions.
  • In 2015, the law creates a physician value-based payment program to promote increased quality of care for Medicare beneficiaries.