Vice president and chief medical officer of Blue Cross and Blue Shield of Texas, Dr. Dan McCoy, spoke to a full room recently on the Affordable Care Act’s impact on doctors, hospitals and health care delivery.

The presentation, held in Levin Hall, was part of the Healthy Health Policy Lunch & Lecture series from the Office of Health Policy and Legislative Affairs.  In his early years, McCoy trained at UTMB as a dermatology resident and was happy to be back on campus.

He explained the 10 minimum benefits that must be provided on each insurance policy purchased through the insurance marketplace:  hospitalization, emergency services, lab services, maternity and newborn care, mental health and substance abuse services, prescription drug services, habilitative and rehabilitative services, ambulatory services and pediatric care, including vision and oral care. 

Individuals and small businesses can choose from one of the four coverage level plans below, which are available on and off the marketplace website. 






Below are some of the ways physicians and medical providers will be impacted by the Act:

  • Some previous charity cases will become compensated cases, as these patients now have access to health insurance through the marketplace.
  • Insured patients cannot exhaust their benefits.
  • Increased Medicaid payment for primary care doctors.
  • Increase in physician reimbursement E&M codes, a medical billing process used for reimbursement by Medicare, Medicaid and private insurance plans. 

McCoy also explained how the new laws are shifting health care delivery toward a more value-based care delivery model with a pay-for-performance platform.  Under this new model, physician and hospital Medicare, Medicaid and insurance reimbursements are based on patient outcomes and the quality of care they received. 

To view McCoy’s presentation and learn more about the Affordable Care Act’s impact, click here.