Categories: Health Care,

Previously, our health care lawyers in Florida discussed the ways in which the Medicaid pay raise expiration will affect primary care physicians practicing in the state. This change led to a nearly 50 percent cut in pay for doctors offering services to Medicaid patients in 2015. Now, we are taking a look at other big upcoming changes — some positive, some negative — that will heavily impact pay rates for physicians this year.

High Deductibles

Deductibles are on the rise and in 2015 and many physicians will be facing deductibles of $1,000 or more that need to be collected from patients. According to a 2014 study from the Kaiser Family Foundation, eight out of 10 insured patients have a deductible, and 18 percent of these deductibles are at least $2,000. The Affordable Care Act requires everyone to have health insurance, which is pushing the deductibles up even higher.

While high-deductible plans have lower premiums to attract consumers, they also mean the patient is the one who pays for most doctors’ visits, not the insurance companies. As a result, doctors will have a harder time getting payment from patients, and will likely be sending more and more bills to collections agencies.

Malpractice Premiums

As deductibles are rising, malpractice premiums are continuing to drop, especially for certain practices like OB-GYNs, general surgeons and internists. For the seventh straight year, the Medical Liability Monitor has reported malpractice insurance premiums dropping for these specialties in its annual premium survey. The 13 percent decline in premiums across the country since 2008 has most doctors paying out less for insurance coverage, although certain specialties and states continue to charge higher premiums.

ICD-10

The official launch date of the International Classification of Diseases, 10th edition (ICD-10), is set for Oct. 1, 2015. The new coding system was slated to start last year, but was postponed to get small practices and vendors and payers ready. ICD-10 has been touted as a more precise way to code diagnoses and assemble data. As the date nears, debates regarding the system’s effectiveness have some doctors all for it, while some are concerned that potential snags — technology problems, coding errors, etc. — will cause major delays in payment.

ACOs

2015 is the third anniversary of Medicaid’s accountable care organizations (ACOs), which signals the end of the program’s three-year shared-savings contracts. The ACOs will begin to lose funding as these contracts expire, and organizations that stay in the program may be forced to take on downside risks and hefty financial penalties. The model for ACOs is the Pioneer ACO, which has been dropping in number. Pioneer ACOs that do not meet their targets might face penalties, and physicians who join them may be risking their own earnings.

At Lubell Rosen, our attorneys are keeping up-to-date on changes that may be affecting physicians’ incomes this year. If you have questions about these changes or need legal advice, contact one of our health care attorneys today.