medical doctors who have been closely watching how the new Patient Protection and Affordable
Care Act (ACA or “Obamacare”) is developing, especially with the ongoing changes to the eligibilities
of coverage for patients and reimbursements that now require their facility to change its systems and
processes for compliance.
PRIMARY CARE Scenario
Scenario
A family practice that serves over 4,500 patients is owned by three brothers, all general practitioner
medical doctors who have been closely watching how the new Patient Protection and Affordable
Care Act (ACA or “Obamacare”) is developing, especially with the ongoing changes to the eligibilities
of coverage for patients and reimbursements that now require their facility to change its systems and
processes for compliance.
As a health care consultant, you have been retained by the family practice to perform a thorough audit
and analysis of the facility, including its systems, processes, and procedures, with an emphasis on record
keeping and coding/billing practices.
You have also spent some time with the owners of the family practice discussing what the future holds
regarding the types of treatments, demographics of patients, and the effect of technology on the
methodologies of patient treatment. Within this context, the client asks you to provide the following:
Questions:
1. When comparing the overall health care system in America, how does it compare to just 40
years ago?
2. Provide some examples of what specifically is critical for the health care organization to consider
regarding how treatments are performed on patients.
3. What technological advancements do you predict in health care in the next 15 years, especially those
that can be opportunities for a family medical clinic scenario?
4. What are the regulatory agency changes coming in the near future?
5. What are your predictions for the success of the ACA, especially in the next 5 years?
