The impact of the Affordable Care Act (ACA) has initiated significant changes across the healthcare spectrum, including changes in the delivery of services and payer-provider claims processing rules.
As the rate of insurance enrollments continue to climb, so will the number and value of claims. At the close of 2014, the changes in the Affordable Care Act resulted in 5.83 million more people with individual-market coverage, 4.93 million fewer individuals with employment-based coverage, and 7.49 million more individuals covered by Medicaid, according to The Heritage Foundation.
The beginning of January 2015 marked the start to the employer mandate enforced under the Affordable Care Act, and although the employee penalty initiated under this act is meant to lower the cost of staffing, a majority of both midsize and large employers still do not feel fully prepared to comply with the mandate’s requirements, according to a recent ADP study.
The three main areas of uncertainty for most employers include: The SHOP exchange process, annual healthcare reporting to the government, and Penalty management.