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Health Care Reform and Your Practice

The Affordable Care Act (ACA), also known as Health Care Reform (HCR), likely hasn’t had much impact on how you treat and provide care to your patients. You may have seen:

  • the same level of service; and
  • reimbursement, billing and claims practices have remained unchanged.

The ACA likely has had little impact on most of your dental patients.

Your patients who receive their dental benefits through work likely have not been greatly impacted by the ACA.

Your patients who work for small businesses may have seen some changes.

The ACA imposed a requirement for small business employers – those with fewer than 50 employees or fewer than 100 employees in some states - to offer certain health benefits.

  • For these businesses, employers are required to offer a health plan containing 10 essential health benefits, including pediatric dental benefits for children up to age 19.

To help small businesses provide plans that comply, the ACA also required each state to establish a health insurance marketplace or participate in the federal health insurance marketplace.

  • Every small business employer chooses whether to participate in one of the marketplaces or offer ACA-compliant insurance on their own.

So, some of your small-business patients may have seen changes to their dental plans or sign up for dental benefits differently. But, again, that shouldn't affect how you provide care or are reimbursed.