OPTUM NP'S

Good Morning!!  i know this is a little late, as i have had much to do!!  i wanted to give my thoughts on the Affordable Care Act (ACA) and what may happen.  As you all are aware, the Supreme Court upheld the State subsidies allowing those States, that didn’t create their own exchange, to receive the monies. this was a pivotal decision further cementing the Affordable Care Act as law.

with this decision the major insurance companies will start making moves to consolidate costs and increase patient base, in other words, increase economies of scale.

Aetna just announced a $37 Billion buy of Humana. Centene Corp announced a $6.3 Billion buy of Health Net Inc.  Don’t be surprised if United Health Care buys both Aetna and Cigna!

Moving forward, i truly believe that CMS (Centers for Medicare and Medicaid) will give the majority of their patient base over to the managed Medicare programs (i.e. HMO’s).  i suggest if your patient base is primarily traditional Medicare, you should look at aquiring as many HMO’s as you can.  the fee schedule will be lower, but you will have a larger patient base to pull from.

Remember, all the Affordable Care Act offered providers was an increase in patient base.  it did not offer exclusive contracts or large fee schedules.  Start adjusting your business model to reflect these changes.

to read further on this merger:  http://finance.yahoo.com/news/aetna-nears-deal-buy-humana-013240008.html