Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

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How Can the Affordable Care Act Improve on Women’s Healthcare?

By Stephanie Reardon

Women are most impacted by unmet health needs due to financial burdens, in spite of the ongoing effort by physicians to lower healthcare costs.

- Despite new provisions of the Affordable Care Act (ACA), women are 24.4 percent  more likely than their male counterparts to express that they and those they care for had issues or were unable to pay medical bills, a survey from the Urban Institute reported. The results from this survey find that women are most impacted by unmet health needs due to financial burdens, in spite of the ongoing effort by physicians to lower healthcare costs. Often these costs go unpaid, and are shouldered by the providers.

Women report having unmet healthcare needs 40.2 percent more than men. A majority of these unmet needs include contraceptive prescriptions and other family planning needs due to costs. More than one out of every 10 women said they did not have these needed services due to the cost.

The ACA has sought to provide more coverage to women than previous healthcare provisions allowed. According to the National Partnership for Women and Families, the ACA allowed nearly 19 million women, who were previously uninsured, to be eligible for health coverage. The provisions of the ACA prevented insurance companies from charging women more (a process known as gender rating) for health care coverage, and guaranteed preventative coverage such as birth control, cervical cancer screening and mammograms without a copay.

Although the passing of these various provisions of the ACA lowered the levels of unmet healthcare needs, the survey from the Urban Institute shows that 50 percent of women with lower-incomes reported having them. Of these unmet needs, women reported that 30 percent of them included medical care, prescription drugs and dental care.

The expanded availability of healthcare to lower income women did not completely eliminate the various unmet needs these women face. For women that have had 12 months of health insurance coverage, 33.5 percent of them still reported one unmet healthcare service need. Additionally, 20 percent of these newly insured women still report having problems paying for medical bills.

The study says that the result of this information points towards a greater need for dental healthcare coverage. Approximately one out of four women (23.3 percent) are covered by medical insurance and reported an unmet healthcare need for dental health services because of cost. Dental benefits are often not covered by insurance plans or Medicaid.

Insurers have untapped areas such as dental which, if insured, would increase the need for hospitals and primary care physicians. This will mean providers will have to be ready to meet this possible increase in need. Family planning services are shown to be the least reported for unmet healthcare needs. However, approximately 10 percent of young women (women between the ages of 18 and 25) said that they still had an urgent need for family planning services as of June and September 2014.

Women between the ages of 26 and 44 made up the highest percentage group for having unmet healthcare needs for financial reasons. Specifically, 47.1 percent of women between the ages of 26 and 35 said they had an unmet need because of the cost.

Providers are aware of the financial burdens their patients may face and many are striving to lower healthcare costs. An article previously published on RevCycleIntelligence.com, discussed the Department of Health and Human Service’s new initiative to fund medical providers that streamline their processes to provide a value-based, patient-focused system of care.

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