Major Shifts in ACA Offerings for 2017: Is Your Practice Prepared?

 In Affordable Care Act, Articles, News

With a dramatic decrease in participation in ACA exchange plans by some of the nation’s largest insurers, UnitedHealth and Aetna, many individuals will be left with a single choice for an ACA plan in their geographic area. In 2016, 36% of counties served had two or fewer options on the Marketplace, and that percentage is expected to increase dramatically for 2017.

As the open enrollment period begins on November 1st, many individuals may look to their providers for assistance and advice on the best options for coverage so they can continue seeing the providers they know and trust. Has your practice considered ways in which you can help educate your patients?

Here are a few tips to help lessen the burden of these payor shifts for your practice and your patients:

  1. Go to and look up the top zip codes where your patients live – what are their choices on the marketplace?
  2. Is your practice in network with all the options offered in your area? Are you in network with ALL plans offered by that payor or only a subset of plans?
  3. View the provider directories for your top payors to ensure their websites reflect your practices correct status and demographic information.
  4. Update your PRACTICE website with the plans you participate with and highlight the individual ACA plans that you participate with for 2017.
  5. Educate staff at all levels about the plans you participate with in 2017 so that they can help educate your patients that may be affected by the pull out of some payors on the marketplace.
  6. Review your protocols for identifying patients that have pended coverage for non-payment of premiums during their grace period. How do you handle these cases and do you collect upfront?
  7. Know your local resources that aid members in ACA enrollment changes.

Does your medical practice need more assistance? Contact MSOC Health today.

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