This study determines the possible effects of the Affordable Care Act (ACA) on a large WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) medical education program which trains primary care health professionals for rural regions. Under the ACA, demand for primary care health professionals increases as more people will get health coverage. Medical schools are accepting more students to satisfy this demand, but there are limits on graduate medical education and residency positions are also limited. This will still result in insufficient supply. The authors examine the impact of ACOs (Accountable Care Organizations) on this program and resulting challenges in the recruitment and retention of health care workforce. The program currently focuses …show more content…
The ACA funding mechanisms help rural communities and offer rural physicians bonus payments and primary care incentives. Hospitals with lowest Medicare spending receive additional funding and there is 1.0 floor on the wage index for frontier states. These factors should help out rural health care. The ACOs can be challenging because the requirement for Medicare ACOs is at least 5,000 fee-for-service beneficiaries, which may be difficult for a rural health care facility. It will have to work with an out-of-area health system which means increased referrals to urban-based centers. The volume of new patients on Medicaid with lowest reimbursement rate is expected to increase under the ACA and more funding will be required to update information systems. Physician shortage, especially in primary care, is more pronounced in rural areas under the ACA and this problem cannot be solved by merely increasing the number of medical students without providing more residency positions available to them. The good news is that rural communities already have more in and across location networking than urban areas, which would be useful in the development of integration required by the ACOs. These will also provide more opportunities to train health care professionals. In my opinion, while this article discussed the ACA’s impact in great detail, it did not address resolutions sufficiently. The issue of primary care physician shortage can be solved temporarily by using nurse practitioners and physician assistants in a new primary care model, allowing them more independence to practice in order to keep up with the demand for primary