When the ACA is implemented next year, millions of newly insured individuals will join the system. Healthcare in America is expected to go through many changes – and the same changes could directly impact the workers’ compensation system. We do not know what the future will bring, but possible delays in access to care could increase disability durations and raise claim costs.
Primary care physicians are often the first to treat workers’ compensation injuries. With the expected shortage of doctors and nurses, physician assistants and nurse practitioners may become part of the standard healthcare delivery model.
We may also see changes in accountable care organizations (ACOs), which are designed to increase quality and improve coordination of care. In recent years, ACOs have grown from groups of doctors to large health plans working with hospitals, health systems, and physicians to create patient-centered treatment programs. They seek to manage everything from wellness to chronic disease. ACO members would like full electronic information sharing and want to move from a fee-for-service payment system to value-based reimbursement programs. Patient-centered medical homes are the ACOs of the future. With patient care teams and self-service information, they are designed to improve quality and decrease costs for payers and consumers.
In addition, continued consolidation among health systems, hospitals, and physician organizations is expected. By consolidating, they position themselves to provide end-to-end patient management, streamline health records management for patients, and offer providers access to an online health information exchange within each system.
After the ACA is implemented, healthcare delivery will include a shift from the current injury-based approach to a health advocacy model that promotes patient engagement. Health advocacy puts the consumer first by focusing on timely care, and increased communication between patients, payers, and medical providers.
You can read our expanded thoughts on this topic in Sedgwick’s latest white paper, “Understanding and preparing for the impact of the Affordable Care Act,” and I will address more key topics related to health reform in future blog posts. I invite you to join my LinkedIn group – Transforming Healthcare for Tomorrow – and share your thoughts.
Kimberly George, SVP, Senior Healthcare Advisor
Want to learn more about the impact of the Affordable Care Act on workers’ compensation? Kimberly George talks more about the major issues in this short interview http://youtu.be/t3evbOq3rWE.