I doubt many will be shocked to find out ACA is working. But here is one more point of proof from the front lines of Health Care.
HIPPA is going to require a change in the billing codes for health care starting 1 Oct, which means more work for us to 'get it right' so bills will get paid. As a result we got to spend half of our monthly training going over the changes and what we need to do to get bills paid.
The start of the training compared the billing from 2013 with today: 2013, "self pay" (uninsured) was 17% with just under 5% of that making payments. Medicare was 37% and Medicaid was 19%. The rest were private insurance.
In 2015, we are running 9% "self pay" with 11% of that making payments, 29% Medicare and 27% Medicaid.
We have seen an almost 50% reduction in self pay and a doubling of the number of self pays that are paying. Medicaid has gone up but we are getting paid now...granted they don't pay nearly what it cost to provide service but we are getting something now. Medicare went down in % but up in total numbers. The reason it is smaller now is more people have insurance making medicaid less common. (not because more older people have died)
Our service is still losing money every year, but it is losing less now that more people have insurance of any kind. (2013 brought in 14.1 million and had a 23.8 million cost, 2015 -july 14 to july 15- brought in 17.8 million with 23.5 million cost) Our call volume has increased as well, 2013 98,000 calls and 21,000 additional calls given to private services that aggressive bill and collect. 2015 110,000 calls with 23,000 passed off to private services. We are on track for 125,000 this year. (down side of insurance, if you have it you tend to use it)
Of course our service has been doing a lot of things to improve the bottom line like being slow to replace employees, slow to get new equipment, imposed "turn around time" rules, and is pushing for increased response times by moving squads all over all the time. On top of dragging their feet on contract negotiations so our pay has been frozen since the contract expired.
With the new IDC-10 program, we are being pressured to "better document" exactly what is wrong with the person so Medicaid and private insurance can't refuse the bill as "vague". Medicaid has already started rejecting some bills because the person had no medical necessity to be transported by ambulance, and Medicaid won't allow the service to bill the person if they reject the bill. But the law says 911 can't refuse to take a person who says "i want to go to the hospital". (private insurance has started rejecting bills for not taking people to the closest appropriate hospital)
My personal feeling is the insurance companies and Medicaid are going to get really aggressive on our reports and start rejecting everything to reduce their costs and that increased revenue we have been seeing will go away.