Checks and Balances: Preparing Your Organization for the Affordable Care Act’s Reopening

It’s critical your organization has a game plan in place to keep your costs in check and your budget balanced.

It’s critical your organization has a game plan in place to keep your costs in check and your budget balanced.

Joe Biden’s presidency came with the promise of making healthcare more affordable and accessible. The president recently took the first step toward that goal by signing an executive order that reopened access to the Affordable Care Act’s (ACA) Health Insurance Marketplace.

A special enrollment period for Healthcare.gov insurance markets will open February 15 and run through May 15. That means roughly 15 million uninsured Americans who missed the deadline to sign up for health insurance through the Affordable Care Act Exchange will soon have the opportunity to get coverage.

According to a new report released by the Kaiser Family Foundation, the Biden administration has $1 billion in revenue from unspent user fees – which pay for most of the Marketplace’s expenses – that could be invested in making it easier for people to sign up. That could also include marketing efforts to boost enrollment.

Many healthcare organizations’ bottom lines have already been decimated by COVID-19 patient care. An increase in newly insured people could result in an uptick in patient visits as well.

It’s critical your organization has a game plan in place to keep your costs in check and your budget balanced.

Zero in on Consumables and Purchased Services

Supply Chain costs often account for a large portion of most healthcare facilities’ budgets. There’s no doubt medical equipment is expensive, but medical supplies and upkeep services can quickly run up a tab as well.

Having vendor quotes for capital equipment and service contracts analyzed to make sure you aren’t overpaying is always a good idea. It’s equally important to have quotes for consumable items and purchased services reviewed too.

Keep an Eye on Contract Management

Contract management can be overwhelming if you don’t have a plan. Sorting through contract clutter can be not only time-consuming, it can also result in fines if you aren’t careful.

The last thing you want to face is a possible increase in patients coupled with a compliance fine that could range from thousands to millions of dollars. Having a contract analytics tool powered by artificial intelligence watching your back keeps money in your pocket.

Reevaluate Provider Enrollment

An increase in patients could result in a demand for physicians. Not having your doctors enrolled in the proper health plan could cause delays that turn into losses ranging from $100,000-$300,000 per provider per month.  

A plan that allows your organization to quickly get the right physicians credentialed, privileged, and enrolled allows you to get them where they’re needed – when they’re needed. Avoid delays and losses by implementing a provider onboarding solution.

We offer the tools professionals in supply chain, contracting, and provider management need to optimize business decisions. Contact your Client Executive to make sure you have the solutions you need to prepare a solid foundation before the Health Insurance Marketplace reopens. Also, to learn more about other ways to stay financially viable in these uncertain times, download our whitepaper, “Measure it to Manage It: Beginning the Journey to Hospital Financial Wellness.”

Author:

Noel Smart

Client Services Specialist

Noel Smart joined TractManager in 2019 as a part of their Young Professionals Development program.

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