12 Changes That Will Affect Doctors' Income in 2015

Leigh Page

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November 25, 2014

In This Article

Get Ready for Some Big Changes in 2015

The new year will bring several developments, some of which may be troubling to physicians, and others that may bring welcome news. These changes can affect physicians' incomes to varying degrees and are likely to have at least some effect on many or most practices.

The following list highlights these upcoming challenges. See which ones may affect you, and what you should watch out for.

1. The Rise of High Deductibles

In 2015, physicians will have to squarely face the growing problem of high deductibles of $1000 or more and find better ways to collect them for patients. Eight out of 10 covered employees now have a deductible, and 18% have deductibles of at least $2000, according to a 2014 study[1] by the Kaiser Family Foundation.

The Affordable Care Act (ACA) requires everyone to buy insurance, and people are drawn to high-deductible plans because they mean lower premiums. Coverage in the ACA's health insurance exchanges, or marketplaces, is pushing levels even higher. A bronze plan has an average deductible of $5000 for individuals and $10,000 for families, according to a report[2] by the consulting firm HealthPocket.

"Deductibles are out of control," said Brette Williams, who is in charge of provider education at Everest AR Management in Gainesville, Florida. When patients with high deductibles come in for care, doctors' offices risk not getting paid or having to make major, repeated efforts in order to get paid. Williams said that in a growing number of cases, the patient—not the insurer—is the main source of payment. The combination of high deductibles and a weak economy mean that "patients today owe more and have less," she said.

Increasingly, physicians' offices have to send delinquent bills to collection agencies, which provide a fraction of the payment owed. According a report[3] by NerdWallet, a service that reports medical costs, one in five Americans will be contacted by a collection agency about a medical bill.

Practices can fall back on several familiar methods to help ensure payment, such as asking for payment up front or putting patients on a payment plan. They can also provide cost estimates in advance, which a growing number of patients are already demanding. "There is more pressure to provide estimates of what services cost," said Robert Wergin, MD, president of the American Academy of Family Physicians (AAFP).

Patients who are sensitive to costs are more inclined to shop around for healthcare services. New websites, such as Compared Care and Clear Health Costs, provide cost estimates for a variety of medical services in selected metropolitan areas. And in May, Aetna, Humana, United Healthcare, and the Health Care Cost Institute announced plans to start a website showing price ranges and average reimbursement for healthcare services.

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