As we move into 2014, we realize the healthcare landscape in the United States will continue to change and evolve. Parts of the Patient Protection and Affordable Care Act (PPACA or ACA) are now in effect with a few delayed provisions scheduled to be implemented later this year or after.
We are frequently asked how the ACA is going to impact our business. Or how do we foresee the business outlook for Chapman Consulting in the coming year. Right now the answer is simple: even more opportunity.
- Hospital charges are still outrageous.
- Out-of-Network claims are on the rise as more physicians and hospitals are opting out of participating in insurance plans associated with the ACA.
- Insurance companies, insurance adjusters, and attorneys dealing with high dollar healthcare claims are all looking for fair supportable reductions that cannot be denied in the claims or litigation process.
- More and more businesses, TPA’s, and claims handlers are realizing that the percent discount they are allowed through their health insurance contract is NOT a good deal when it comes to extreme hospital charges.
Hospital charges and healthcare costs in general continued to increase in 2013. The ACA does not address hospital pricing. And all of the media attention focused on hospital price transparency hasn’t appeared to make a dent in the charges either.
In our estimation, the ACA will lead to an increase in the number of out-of-network claims in the healthcare marketplace leaving payors of those claims in a precarious position.
Our business with insurance companies and insurance adjusters continues to expand. Certain claims require expert assistance with the kind of data and reports only a highly specialized bill review company like Chapman Consulting can provide.
Our business with attorneys grew exponentially in 2013 and the trend continues this January with new attorneys contacting us daily. The feedback we get from attorneys is excellent. They are amazed by the professionalism of the reports and the defensibility of the data.
Factoring in these points and many others, the business outlook for 2014 is excellent for Chapman Consulting. We are optimistic it will be another great year. We look forward to serving our current clients and greeting our new clients with the professionalism, integrity, and dependability we are known for.