How Will a New Era of Healthcare Entrepreneurs Be Impacted by the ACA?
At some point, the gig economy was bound to expand into industries most never imagined. With the growing rate of Americans taking on some form of a job within the gig economy, it’s become something that many employers are seeking to understand and, in the case of the federal government, regulate. The healthcare industry is no exception.
Companies like Nomad Health, where freelance physicians are matched with hospitals who need their assistance to address patient demand, along with startups like American Well, a telehealth platform, and Doctor On Demand, a service to connect patients to a doctor online, are starting to make their mark in healthcare. These “temporary” physician positions may have once frowned upon in the medical field, but the gig economy has sparked a renewed interest.
To many, it’s arguably an ideal way to address healthcare needs of hospitals and medical facilities to meet a growing demand for medical services spurred by more Americans having health insurance because of the Affordable Care Act (ACA). According to a recent study by medical staffing agency Merritt Hawkins, the average wait time is 24 days to schedule a new patient appointment with a family medicine doctor in 15 of the major cities in the U.S., with Atlanta’s wait time at 27 days, Los Angeles at 42 days, and Boston at a whopping 109 days. Having the flexibility to provide physicians where they are needed most, and providing those doctors with scheduling and lifestyle flexibility, are some of the key advantages of the growing freelance movement in healthcare.
However, complying with the ACA may pose challenges to companies in the gig economy. Physicians are known for clocking in long but not necessarily predictable hours to meet the needs of their patients. In general, the ACA requires an offer of coverage to any employee that clocks in 30 hours within any week. This would include those companies employing freelance physicians. If they qualify as full-time employees under the ACA, must these physicians be offered healthcare by the agency that assigns them work or the hospitals where they treat their patients?
There are also issues of differing employment arrangements. For instance, Nomad has indicated it will hire nurses as employees and provide benefits, but that physicians will be retained through the company as independent contractors. How will this difference in classifications impact how Nomad complies with the ACA? What if that classification is challenged?
The ACA has opened the eyes of Americans to both their rights to adequate healthcare and the challenges of meeting a growing demand for healthcare services. These new healthcare solutions spurred on by the gig economy may prove to be what the doctor ordered. However, meeting the requirements of the ACA may be a stressor that even a doctor can’t cure. That’s something that only Congress may be able to remedy.
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