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Friday Aug 02, 2013

Do Your Patients Know How Health Care Reform Will Affect Them?

Health care marketplaces created by the Patient Protection and Affordable Care Act are scheduled to open for enrollment Oct. 1. Unfortunately, fewer than one-fourth of Americans are aware that the marketplaces -- formerly known as exchanges -- exist, according to a Kaiser Health poll released in June

In fact, fewer than half of U.S. consumers are aware that the ACA is being implemented, according to a poll released by Kaiser Health in April.

Kaiser Health's April poll said that 12 percent of consumers thought the health care reform law had been repealed by Congress, and 7 percent thought it had been overturned by the Supreme Court. Consumers who are unaware that the ACA is being implemented aren't going to be ready for enrollment deadlines and likely aren't aware of new services and benefits available to them.

Where are consumers hearing about the ACA? Forty percent of respondents said they were getting information (possibly misinformation) from friends and family. Roughly one-third named news outlets as their source of information.

Only 11 percent said they had received any information about health care reform from their physicians. In a more recent poll by HealthPocket, a website that compares health plans, half of respondents who had a primary care physician said they had not talked with their doctor about how the law will affect them.

But, providing good information to help our patients make informed decisions about their health care is something we do every day, and that's what we need to do now to help make sure our patients are aware of the options open to them. 

In the short term, physicians can direct patients to a FamilyDoctor.org web page that addresses common consumer questions. Consumers also can get information about health insurance marketplaces -- and find out if they qualify for lower premiums and lower out-of-pocket costs -- at www.healthcare.gov.

A question-and-answer article in Family Practice Management also addresses numerous ways the ACA will affect family physician practices.

In addition, the Academy is working on developing resources to help physicians answer patient questions and to address how the law will affect our practices. Those resources are expected to be available September 3.

The bottom line is that family physicians need to be informed. We need to look at the parts of the Affordable Care Act that are good for our patients and make sure they are prepared to benefit from those provisions. We also need to be aware of how our practices may benefit from health care reform. We also need to continue to identify areas of the law that are not good for our patients or us and work to change them. We should find those aspects of the law that have potential and work to improve them.  And we need to be able to answer our patients’ questions about how the law and its implementation will affect them. 

Reid Blackwelder, M.D., is President-elect of the AAFP.


In about 20 states that have opted not to participate, the burden of informing patients about major health systems changes will fall upon family physicians, their practices, and the facilities associated with family physicians. This is particularly true for half of the rural US population or about 8% of the US population that is found in 1000 counties. For 30 years and still counting, these are counties disadvantaged in health, education, and other spending with higher proportions of Medicaid, Medicare, diabetic, elderly, disadvantaged, rural minority, lesser educated, less employed, and less health care covered populations. About 8% of FM docs are found serving this 8% of the population, despite the challenges. Informing patients is yet another forced function of multitasking front line family practice. One thought would be for state associations to network with practices to gather federal funds to gather some resources together to do something that must be done anyway. Students interested in health careers or medical students would be another resource to explore.

Posted by Robert C. Bowman, M.D. on August 08, 2013 at 07:59 PM CDT #

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