Health Insurance Exchanges Open Tomorrow: Are Ambulatory Surgery Centers Ready?

The health insurance exchanges will open tomorrow and consumers can begin shopping and purchasing health insurance coverage through the exchanges. The open enrollment period runs through March 2014 and coverage begins as early as Jan. 1, 2014, according to an ASCA Government Affairs Update.

ASCs that are covered under the Fair Labor Standard Act must provide a notice to all employees by tomorrow that informs them about exchanges in their state; the potential for federal tax credits if they purchase insurance from the exchange; and that purchasing through the exchange could mean they lose employer contribution to the health plan the ASC offers, according to the report.

Due to rate increases, some employers are considering opting out of employee coverage and taking the penalty instead because paying the penalty would be cheaper. However, this could leave employees with unfavorable options on the exchange.

"Nobody knows for sure, but there have been predictions that the value equation for plans on the exchange won't be as good as the employer-offered small group plan," said Tom Jacobs, CEO of MedHQ, in a Becker's ASC Review report. "You might be giving employees a less attractive benefit, and many businesses depend on their insurance plan to help attract great employees. If you are doing something to diminish the health plan, you might not attract those employees."

According to a report in Reuters, health insurance exchanges will likely still have access to funding if Congress shuts down on Oct. 1. The District of Columbia and 16 states are currently set to receive their new HIE funding.

However, if the government shuts down its unclear whether the PPACA data hub, which gathers information from federal agencies and state governments would continue to run. The hub will also be used to process applications for health insurance and determine eligibility for tax credits to cover premium costs.

Regardless, surgery centers around the country are preparing for an influx of patients on high-deductible plans purchased on the exchange.

"There are a number of things [ASC leaders] can do, but you have to look at your strategies market-by-market," said Kim White, MDA, a consultant with Numerof & Associates, in a Becker's ASC Review report. "Are the health insurance exchanges government-run or privately-run, or is it a combination? The essential health benefits define specific services that are covered and some states will extend those benefits. Is there an opportunity for the ASC to fit within the exchange in some way? Do we need to partner with someone who is selling plans on the exchange?"

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More Articles on Surgery Centers:
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7 Ways to Use Key Quality Metrics to Improve Gastroenterology Centers

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