Ironically, the multiplication of mandates and other regulations in the ACA on both private insurers and government-run programs like Medicare and Medicaid have more doctors opting out of the third-party-payer system altogether. Earlier this week, CNN Money reported on the migration to cash-only services among health-care providers, driven by poor reimbursements, increasing regulation, and high overhead.
Dr. Doug Nunamaker, a family-practice physician in Wichita, knows that his decision will eliminate some of his demand, but the cost savings and the freedom more than make up for any business lost over his refusal to take insurance. "The paperwork, the hassles, it just got to be overwhelming," Nunamaker told CNN.
Nunamaker and the increasing number of providers pursuing this option have to court aggressively a smaller market by competing with each other on price. Fortunately, with the mandates and reimbursement headaches removed, that becomes much easier to accomplish.