Earlier this month, the American Health Care Act won passage in the House, shaking up the healthcare industry yet again. The proposed bill impacts everyone across the spectrum, including 25 million low-income and underserved patients and communities served by our customers.

At PointCare, we are actively reviewing the details of the new bill and how it impacts the coverage landscape. We do know that this bill places more power in the hands of the States to determine the fate of their health coverage landscape. As we have seen changes in health policy in the past, the fact is that it will go through several iterations between the House and Senate before getting signed into law. We anticipate 3 to 5 years before we know and feel the real impact of the law, similar to what we saw with the ACA.

In preparation for the changes coming to healthcare, we must be well versed on what to expect and most importantly, be proactive in our approach to providing quality care to our communities. We’ve outlined a few items on the bill that together, we can attack head on, regardless of the outcome of the AHCA.

Consumers who let their coverage lapse for more than 63 days in a year would be charged 30% surcharges to regain insurance. This would include people with pre-existing medical conditions. Through proactive and diligent coverage management, you can develop a process to catch people when they fall out of coverage and get them re-enrolled to ensure coverage while keeping premium costs down.

End to Medicaid expansion funding. FQHCs in particular, need a framework for sustainable funding outside of grants. This can be done by generating more covered patient visits for better reimbursements across the board.

Changes Medicaid from an open-ended program to one that gives States fixed amounts of money per person. It’s more important than ever to work with your patients to promote coverage consistency. Knowing what your patient is eligible for remains critical as changes to program eligibility rules are expected to fluctuate.

During this time, we urge our customers to continue to advocate for your patients and work towards making healthcare accessible and affordable for all. With PointCare, we’ll continue to develop and enhance our platform to ensure your coverage management framework allows you to immediately respond to coverage changes in healthcare in real-time.

– Everett Lebherz, Co-founder & CEO, PointCare

Implement a coverage management platform that allows you to adapt to the ever-changing coverage landscape.