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Physician: Consequences of ACA Repeal 'Gigantic for Us'

Analysis  |  By Debra Shute  
   February 09, 2017

Physician organization leaders are trying to plot business strategies for a post-ACA landscape of increased healthcare consumerism, lower reimbursement, and new partnerships.

Attendees invited to attend the first annual HealthLeaders Media Physician Organizations Exchange, in La Jolla, CA in December, discussed the fate of the Patient Protection and Affordable Care Act and assessed a post-repeal-and-replace future for their organizations in stark business terms.

Physician organizations of all sizes are taking a hard look at the revenue they stand to lose if the individual mandate and Medicaid expansion end, how they might work with private insurers, and what strategic pricing and partnerships they can build.

'Devastating' Changes
Simply put, the business implications of a potential ACA repeal are "gigantic for us," says William R. Hathaway, MD, FACC, chief medical officer and senior vice president of Mission Hospital, a 763-bed medical and surgical hospital in Asheville, NC, a state that did not expand Medicaid.

Cost of ACA Repeal: $1.7 Trillion in Uncompensated Care

"We are heavily dependent on governmental payer sources, with about 70% Medicare, Medicaid, or no-pay. The proposed changes would translate to tens of millions in lost revenue, which could be devastating to us," said Hathaway.

"How do you cut hundreds of millions of dollars out of your system when you're already cutting every year and trying to grow?"

Hathaway isn't the only one who's troubled by that possibility. The nation's uncompensated care bill could soar from $656 billion to $1.7 trillion over a 10-year period if the ACA is repealed with no replacement, according to research from the Urban Institute.

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.

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