MGMA conducted research in April to better understand the impact of the Affordable Care Act's (ACA) insurance exchange implementation on medical group practices. The research includes responses from more than 700 medical groups in which more than 40,000 physicians practice nationwide.

Download the full report.

Overview

Almost 80% of survey respondents reported their practice is participating with new health insurance products sold on the ACA exchanges (ACA exchange products) and more than 90% of these practices have already seen patients with this coverage. Of practices participating with ACA exchange products, 85% are contracting with one to five products and almost 60% reported they are participating in order to remain competitive in their local market. While more than 8 million consumers have enrolled in health insurance coverage through the ACA exchanges, 56% of respondents reported no change in their practice’s patient population size through April and 24% reported a slight increase.

Practices expect a small shift in this trend through the end of the year. Thirty percent of respondents projected no change to their practice population size by the end of 2014 and 44% predicted a slight increase. These figures illustrate that most practices are not being inundated by new ACA exchange patients but do expect to treat somewhat more of these patients as the year progresses.

MGMA noted three main themes within the findings:

Obtaining coverage information

Practices have experienced difficulty in identifying patients with ACA coverage and obtaining essential information related to that coverage.

Patient cost-sharing

Practices are facing a number of challenges related to patient cost-sharing for ACA insurance exchange coverage.

Network limitations

Practices have concerns about the impact of the network design of many ACA exchange products.

Discuss your experience with insurance exchanges with your peers.

Additional information on ACA insurance exchanges:
ACA exchange implementation checklist
ACA Resource Center

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