The major challenge facing physicians is getting paid for the work they do. Healthcare sector has undergone tremendous development in terms of reimbursement models. There has been a shift from fee-for-service models to the current value-based reimbursement models. Physicians are likely to experience hassles in getting payment from health insurers and other health programs. Under the Medicaid program, federal and state governments jointly fund the program. No state contributes more than 50% towardsphysicianpayment for care (Bindman, 2015). The states determine physician payment rates. This allows them to set low payment rates to limit their costs under the program. Thus, physicians and medical professionals end up being lowly compensated for their services.

Under value-based reimbursement model, the physicians get paid for their performance. Some physicians opt against accepting insurance to avoid the challenge of getting paid. The impact of the Affordable Care Act on reimbursement has increased the financial challenges facing physicians. The act stipulates that physicians must participate in the Physician Quality Reporting System (PQRS), for physicians working with Medicare patients. They risk facing a penalty for no participation or when deemed not successful. Physicians are compensated based on their performance.

According to Bindman (2015), states have deliberately avoided increasing Medicaid reimbursement rates to keep pace with private payers. There is nothing to stop them from reducing their paltry reimbursement rates. Bindman uses an US Supreme Court case which overturned a decision to increase its Medicaid reimbursement rates. This shows that physicians cannot use the threat of lawsuits to seek remedy for Medicaid’s low fee-for-service payment rates. In conclusion, physicians face a challenge of getting low compensation for their services under the state regulations.

Reference

Bindman, A. (2015). The Other Physician Payment Problem. JAMA, 313(21), 2112.             https://doi.org/10.1001/jama.2015.4797.