3 steps to protect your practice when insurers exit ACA

A signpost with the words Affordable Care Act

Image credit: Getty/kroach

The exit of a growing number of insurers from the Affordable Care Act marketplaces is having a trickle-down effect on physician practices.

Doctors must educate themselves and protect their practices, P.J. Cloud-Moulds writes in Physicians Practice. Several Blue Cross Blue Shield plans are the latest to exit the healthcare exchanges, following earlier decisions by Aetna, Humana and UnitedHealth Group to leave the market.

It could be the “nail in the coffin” for the ACA exchange plans, she says, but whatever the ultimate result, physician practices need to prepare for the impact. Here are three of her recommendations from Cloud-Moulds, who runs a physician practice consulting firm:

  1. Be ready for patients who are “freaking out” at the loss of their insurance. Practices cannot legally give advice to patients when it comes to which insurance plan they should switch to. You can, however, provide patients with a list of insurance plans that your practice accepts. 
  2. Understand your contracts. If your practice signed up for a reduced reimbursement rate, you will no longer have to see those patients. And end your contracts with those plans. "Sneaky" insurers could try to hide the exchange plan contract amid current PPO plans.
  3. Be prepared for more upheaval. More insurance companies are likely to follow the Blues in existing the ACA marketplaces, so stay informed and keep close tabs on any correspondence from all insurance companies that you accept at your practice.