Q&As with doctors about the Affordable Care Act

Q & A with Bob Seligson, N.C. Medical Society, CEO

Q: What are your thoughts on the Affordable Care Act?

A: "There's a lot of change that's good and there's a lot of change that's not. And ultimately we have to  put emphasis on the change that's good to make the system better."

Q: What will be the biggest challenge in the Affordable Care Act?

A: "Meeting the need for new patients coming into the system that are now going to be insured is the biggest challenge we're facing and also providing more efficient medical care."

Q: How are regulations, both existing before the Affordable Care Act and the Affordable Care Act itself, affecting doctors?

A: "We know from the survey done nationally that they're trying to change the mode in which they're practicing. Some of them are limiting the amount of Medicare patients they're seeing, the amount of Medicaid patients they're seeing because they can't meet their overhead when they provide a disproportionate share of those people in their practice.

Because of the regulatory changes and the hoops they have to go through and the Medicare audits and things like that, doctors are changing how, the type of patients they're seeing or how many patients they're seeing, and they're also cutting down their hours."

Q & A with Dr. Andrew Mueller, Senior Vice President of Physician Services for Novant Health

Q: How will the Affordable Care Act change how patients choose doctors?

A: "I think physicians who are going to be successful are going to be ones who innovate, ones who can be efficient in the care they deliver, but also still deliver care that still maintains high quality.

I think we're going to be able to look up quality scores on physicians here in the near future. Patients are going to be able to shop around to make sure they feel they're getting the best value for the dollars they spend on healthcare in the future."

Q: How will the Affordable Care Act change how patients get care?

A: "I think instead of having care delivered, one on one by an individual practitioner, I think moving forward we're going to see more care delivered through a team. A team may consist of somebody's who administrative, who can answer the phone and take messages and work on billing issues. It may consist of a nurse who's highly  integrated into what the physician's doing and knows the patients individually. It may consist of an advanced practitioner, like a mid-level provider, like a nurse practitioner or a physician's assistant as well as a physician, all working in concert together, to make sure that the needs of the patients are met.

It may mean more time with the doctor when you need it, but time with another care team member when you don't really need to see the doctor."

Q & A with Dr. Justin Favaro, Oncologist, Oncology Specialists of Charlotte

*Dr. Favaro has listed rising insurance costs, the overall cost of the Affordable Care, and something known as "bundling of payments" as his biggest concerns with the Affordable Care Act.

Bundling: An initiative the Centers for Medicare & Medicaid Services is working on as part of the Affordable Care Act. The idea is to get doctors, hospitals and other health care providers to work together to better coordinate care for a patient. For example, the entire team of healthcare providers would be given a certain amount to cover the costs of the patient's care for a specific health issue (i.e. lung cancer treatment).

Q: How do you believe bundling would hurt patients?

A: "It may not cover the more expensive regimens. Every time a patient comes through the door, we treat them the way they should be treated. We choose the regimen that is best for them. That may be the... least expensive regimen or most expensive regimen. It really depends on the patient, what their health problems are. We don't want to be restricted."

WSOC