Obamacare Affects Arlington, Desoto and Fort Worth Texas Health Insurance Reimbursements

More people have insurance but less people can see a doctor.  It’s because doctors are not taking many of the insurance plans offered on the Health Insurance Exchange.  This is not to say doctors are not accepting any of the insurance plans from the exchange, but many on-exchange plans doctors exclude.

Most doctors are members of one, two or all of the following networks; Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), Exclusive Provider Organization (EPO) and/or Point of Service (POS).  On-exchange and off-exchange plans use these networks.  However, many of the on-exchange plans have low reimbursement rates to doctors.  Low rates make on-exchange plans attractive to Health and Human Services (HHS), the administrators of health plans, but unattractive to doctors.  HHS uses these plans to provide health insurance subsidies to low income un-insured persons.  As a result, many doctors view on-exchange plans as money losers.  Let’s examine why.

Hypothetically, if doctors have eight hours a day to see 10 patients and each patient is on a plan paying the maximum allowable for a particular procedure, the doctor will maximize income and cover expenses with each patient.  However, if patients are injected into a doctor’s schedule with lower reimbursement rates, doctors will make less.  This will happen more than less, for the number of persons having on-exchange plans will be greater than the number with off-exchange plans.  In Texas, there are still millions of uninsured residents who would qualify for a subsidy.  As Texas residents receive subsidized plans, many will have health insurance with few doctors participating in the networks.  As for these doctors who do accept on-exchange plans, their queue will increase for their numbers are few.  This is most probable in neighborhoods with minorities, many of which live in Arlington, Fort Worth and Desoto Texas who may be most susceptible to subsidies.

One way to mitigate this issue is to increase the number of facilities that accept patient care and do not use doctors, but physician assistants (PAs) and/or nurses.  This patient care model is occurring in pharmacies such as CVS, Wallgreens and Wallmart.  These establishments administer care for minor ailments that may not need a doctor.  They focus on sicknesses such as colds, fevers, ear aches and other minor illnesses.  This patient care model freezes resources at doctor offices for major illnesses and injuries.  Also, this model reduces costs, for hourly rates in these facilities are less.

Another way to increase the number of persons receiving treatment is “increase reimbursement rates to doctors”.  This will encourage doctors to accept all insurances.  However, by doing this the medium used to extract money for subsides such as taxes on – group health insurance policies and fees on manufactured medical devices will increase. These fees and taxes are already being contested and lobbied against in the US Congress.

Finally, a third way to reduce doctors’ costs is to eliminate doctors’ student loans, thereby making reimbursement rates reasonable.  Doctors need high reimbursement rates to cover expenses.  Some expenses include financed student loans totaling $250,000 or more.  Reduce this expense and reimbursement rates will follow.

This brings us back to the title of this article, “Obamacare Affects Arlington, Desoto and Fort Worth’s Health Insurance”.  In the long run, Arlington health insurance, Desoto health insurance, and Fort Worth Health insurance  can all receive positive effects from more persons being insured.  If each suggestion to reduce cost mentioned above is endorsed, the cost of care would be steady; with more doctors accepting on-exchange insurance plans.  Overall, this would reduce the cost of insurance.  Persons who may have used the emergency room will now have access to a primary care physician; routine physicals will discover chronic illnesses early, thereby reducing the cost of treatment and increasing the quality of care.  To interject a positive note, health insurance in Arlington, Desoto and Fort Worth Texas could ultimately be in good shape in the years to come if changes are made to the overall system.

Insurance4Dallas, (I4D) helps insure all of Texas and provides consumers with detailed information and the ability to apply for insurance online. I4D provides a full spectrum of health, dental, vision, life and other ancillary insurance products providing a diverse selection of price and benefit options complemented by personable customer service. Available via phone, email or fax, Insurance4Dallas answers consumer questions throughout the purchasing process and utilization of the health insurance policy.

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