With the Affordable Care Act changing the face of healthcare in America, we’ve found that many older adults and caregivers are uncertain about how their lives and the lives of their loved ones will be affected.
Today, we hope to start answering some of your questions about how the Affordable Care Act will impact senior healthcare.
1. What parts of my health care will the Affordable Care Act impact?
Quite a few, actually. But don’t panic. These changes are a good thing. They’re going to better the quality of the healthcare and senior services you receive.
Here’s an overview of what to expect:
- Change in payment structure. Currently, providers are paid on a fee-for-service basis, and we will see that moving to a pay-for-performance kind of a system where providers are paid on a defined set of outcomes. Those measurements are beginning to occur now.
- A higher degree of system integration. The world of healthcare is changing, and that is going to have an impact on senior healthcare in particular. There’s definitely going to be greater connectedness, but the specifics of how that is going to play out and how the market is going to respond to the changes is still a bit unknown.
But we know, there’s one question in particular that everyone is looking to have answered, so let’s move on to question two.
2. How will my Medicare benefits be affected?
Let’s clear up one major misconception— Medicare benefits are not going to be eliminated or dramatically reduced.
In fact, the Affordable Care Act is actually increasing a number of benefits including:
- New preventive care plans
- Increased Part D pharmacy benefits
It’s true that some funds, about $700 billion dollars, are being redirected from Medicare to fund the Affordable Care Act, but seniors have power as a voting bloc, and politicians don’t want to lose the support of older adult voters. So, while you may see some higher deductibles and a reduction in a few services, you’re unlikely to see a significant change in your benefit structures.
3. So what is changing with Affordable Care, then?
What’s going to change is the how you, as an older adult, experience senior healthcare.
Currently, the quality of senior care is driven by different kinds of payment structures. The better the payment structure of your plan, the better service you receive.
Affordable Care is going to change this payment structure/quality of service binary.
The Affordable Care Act holds senior healthcare providers accountable for delivering a better patient experience, and seniors across the board are going to be seeing a better quality of care. You’re going to be getting what you want and need from healthcare—better outcomes at a lower cost.
4. What should I expect to see change in the coming year?
You won’t see an immediate dramatic reduction in Medicare Advantage benefits, that’s for sure, but the changes will be noticeable. Because the 2014 plans won’t be released until October, we don’t know what all of the new changes will entail, but it’s fairly certain that we’ll see some change in how insurance programs are structured for seniors.
Insurance companies will see, on average, reduced payments in the 5% range for the 2014 Medicare Advantage plans. The government announced this change in April and insurance companies have already submitted their plan designs for 2014 which show more focus on quality ratings and bonus payments due to achieving star ratings.
We’ll talk more about the changes the Affordable Care will bring to insurance and coverage at a later date, but suffice it to say that we expect to see even more changes to senior healthcare in 2014.