The new law invests new resources and requires new screening procedures for health care providers to reduce fraud and waste in Medicare, Medicaid, and CHIP. There are new incentives in the law to expand the number of primary care doctors, nurses, and physician assistants, including funding for scholarships and loan repayments for primary care doctors and nurses working in underserved areas. Doctors and nurses receiving payments made under any state loan repayment or loan forgiveness program intended to increase the availability of health care services in underserved areas will not have to pay taxes on those payments.
Effective January 2012, the new law provides incentives for physicians to join together to form "Accountable Care Organizations." Through these groups, doctors can better coordinate patient care and improve quality, help prevent disease and illness, and reduce unnecessary hospital admissions. If these organizations provide high quality care and reduce costs to the health care system, they can keep some of the money that they have helped save. Additionally, by 2013 there will be a national pilot program to encourage hospitals, doctors, and other providers to work together to improve coordination through payment "bundling." This means that hospitals, doctors, and providers will be paid a flat rate for an episode of care rather than the current fragmented system where each service or test or bundle of items and services are billed separately to Medicare. It aligns the incentives of those delivering care, and savings are shared between providers and the Medicare program.
As Medicaid programs and providers prepare to cover more patients in 2014, the Act requires states to pay primary care physicians no less than 100% of Medicare payment rates in 2013 and 2014 for primary care services. The law also provides increased payment to rural health care providers to help them continue to serve their communities.
By January 2015, a new provision will tie physician payments to the quality of care they provide. Physicians will see their payments modified so that those who provide higher value are will receive higher payments than those who provide lower quality care.