On March 23, 2010, President Barack Obama signed the Affordable Care Act, commonly referred to as Obamacare, into law. This health-reform initiative fundamentally altered how physicians are paid.
Many doctors fear the Affordable Care Act (ACA) will reduce their salaries. However, research demonstrates that PCP compensation has not declined significantly since enactment of the ACA.
Pay Scales
Doctors’ salaries depend on several factors, including their specialty. For instance, doctors in pediatric infectious diseases typically make around $210,844 annually while neurosurgeons make $773,201.
Salary levels differ across states. Physicians in Alaska make an average salary of $140,000 more than their counterparts working in New York.
Physicians now have the freedom to bargain pay scales. Unfortunately, the system is complex.
Some practices use a productivity-based compensation model, in which doctors are paid a percentage of their own collections plus an incentive based on ancillary revenues. This compensation is linked to the practice’s financial performance which in turn depends on patient mix.
Practice Requirements
Doctors in private practice often struggle to stay afloat as government regulations increase reporting requirements and cost-prohibitive electronic health record systems. As a result, more physicians are leaving their practices for larger groups, hospital employment or new forms of practice that offer greater autonomy and allow doctors to spend more time with patients.
Doctors in the United States tend to earn relatively low salaries compared to other medical professions. Most of their compensation comes from business and administrative perks.
Most doctors report having to adjust their work schedules due to the Affordable Care Act (ACA), with many noting it has created more billing and insurance paperwork. Furthermore, more professionals are taking on additional jobs in order to supplement their incomes.
Physicians who treat a high proportion of Medicare patients will likely be hit hardest by these changes, as they are more likely to receive higher payments from Medicare if their quality-of-care scores and total costs of patient care exceed certain thresholds.
Working Conditions
The Affordable Care Act has spurred more demands for improved compensation and working conditions among doctors, but it also created a political climate that favors single-payer health care, potentially leaving the profession much worse off.
Physicians and nurses working in the United Kingdom and Canada are striking for higher wages. Additionally, they’ve joined unions in an effort to secure a fair wage and better working conditions.
However, their demands will not be fulfilled if we implement Medicare for All. Under this policy, providers would be expected to work longer hours and earn less money.
Studies of working conditions in public hospitals have revealed that unsatisfactory conditions negatively impact workers’ physical and psychosocial wellbeing. To mitigate these problems, various strategies have been identified such as increasing salaries, improving the working environment, addressing healthcare staff shortages and excessive workload, and offering more career and professional development opportunities.
Taxes
The Affordable Care Act has had a substantial effect on physician salaries. Firstly, it has helped slow the rise of health care costs across America.
Furthermore, the law has made access to insurance more readily accessible by requiring plans to cover essential health benefits like maternity, mental health and prescription drugs.
However, the Affordable Care Act has also driven up the cost of coverage for some. To assist those buying insurance through marketplaces, the ACA created premium subsidies.
Unfortunately, subsidies aren’t available in all states. This has left millions of Americans unable to afford health coverage.
Physicians earning less than $315k in taxable income can take advantage of a new tax deduction for qualified business income (QBI), which could save them up to $15,120 annually.
