The Impact of the Affordable Care Act on Payer Mix and Reimbursement in an Academic Plastic Surgery Center

On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). Many have speculated as to the impact of this legislation on medicine, though few have measured its effect to date. The goal of this study was to document the preliminary financial impact of the ACA on an academic plastic surgery practice. The total charges billed to each major payer were compared to the total matched payments from each payer, before and after implementation of the ACA. Our study showed a significant increase in the charges billed to Medicaid (p<0.003), showing its expanding presence in our practice's payer composition. It also found a decrease in re-imbursement from government-managed health plans (p<0.005), as well as a significant decrease in reimbursement from commercial insurers (p<0.05). Even in its infancy, the ACA has had a measurable and notable impact on payer composition and reimbursement patterns.