Much has been said about the jobs impact of the Patient Protection and Affordable Care Act, especially those in small businesses, but there hasn’t been a
lot of focus on the health care industry itself.
How will health care industry workers be affected by the Affordable Care Act (ACA)? For better or for worse, these are the jobs that we expect to be
affected the most by the ACA.
Medical records and billing
Health care support industries, especially medical records and billing companies, stand to greatly benefit from the ACA. As potentially 30 million new
patients will need health care services, they’ll need someone to keep track of all their medical records and billing. In fact, the American Recovery and
Reinvestment act is commonly known as “the stimulus bill” in this industry. It’s already resulted in a $19 billion push to electric medical records, a push
that is set to increase and demand more professionals in this field.
Health care technology
IT services for health care is already a hot industry, and it’s going to get hotter as the health care law demands improvements in technology from
hospitals, doctors and pharmaceutical companies. High tech health care startups are focusing on meeting these needs, with startups developing tools that
allow patients to find doctors with ratings, as well as tools that help health care providers keep up with demand and offer a more consumer-focused
Medical device manufacturers have been in turmoil for a few years already due to market dynamics, and the the ACA ruling is likely to shake things up a bit
more. On the upside, the ACA is likely to bring in millions of new customers, adding demand for more workers and security for existing ones. But it remains
to be seen whether or not the industry can afford those workers as it responds to a 2.3 percent medical device tax that will cut into profits. Gerard
Anderson, professor of health policy and management at Johns Hopkins University believes that the industry will not be able to sustain the jobs, noting,
“medical device companies will hire fewer people.” Surgeons may even begin to choose less expensive medical device models from overseas manufacturers due
to a change in reimbursement models.
Millions of Americans who are now living without health insurance will have new health plans under the ACA, and with those health plans, are likely to seek
out the services of primary care physicians. That means doctors, and especially primary care physicians, will see an increased demand for work. At the same
time, doctors will potentially see a cut in insurance payments. This could mean that doctors will be expected to see more patients, but not receive as much
money per patient.
Medical support staff
As millions of additional Americans begin to demand service for their health care, it’s clear that more workers will be needed to meet this demand. But which
workers will see the most immediate impact? While it takes years to train physicians and nurse practitioners, support staff can be fully
trained in a matter of months. Assistants, technicians and other medium-skill medical jobs will be plentiful.
Skilled medical workers
Another group that will benefit from the increased demand (and shortage) of physicians is what some people call “physician extenders,” workers that do a
lot of the work of physicians, but do not have M.D. behind their name. These include physicians’ assistants, nurse practitioners, and care managers,
allowing physicians to see more patients and keep up with demand.
Yet another fall-out of the coming physician shortage is the need for more urgent care professionals. Patients who can’t wait to see a doctor are likely to
turn to urgent care centers. We will see an increase in physicians creating urgent care facilities, and medical professionals with a background in urgent
or emergency care will be in increased demand.
Medical insurance agents are concerned about job security under the ACA, and with good cause: the insurance industry is getting squeezed by the ruling.
Under the act, individual and small group market insurers must spend at least 80 cents of every dollar in premiums collected on health care. In the large
group market, it jumps to 85 cents. Insurance agent commissions are not defined as a medical expense, and insurance companies may find it difficult to find
money for commissions in their 15 to 20 cents outside of medical expenses. Additionally, the law requires that insurance products must be displayed in an
easy-to-understand, easy-to-compare format, reducing the need for insurance agents that can help make sense of it all.
It’s not just insurance agents feeling the crunch; all health insurance employees are likely to feel an impact. With 20 percent or less left for payroll
and administration, just about everyone working for an insurance company has a target on their back. Additionally, some companies are choosing to get out
of the individual major medical insurance business as a result of the ACA, leading to job cuts in those departments. Last October, American Republic
Insurance announced a move out of the individual insurance business, eliminating 110 jobs.
With lots of new customers, pharmaceutical companies will be working overtime to keep up with demand, and likely hiring new workers. But at the same time,
cost changes may put pressures on drug companies that lead to job cuts. Industry experts like Holly Strom, former president of the California State Board
of Pharmacy, believe that these changes are advantageous only to Big Pharma. Strom believes “only large players would be the ones capable of doing big
business.” So workers with larger pharmaceutical companies are likely to do well, while workers with smaller drug companies may be in trouble.
A version of this article appeared on the Medical Billing and Coding blog, here.