As of counts in the last couple of weeks, 9.5 million people are insured for the first time under the Affordable Care Act. These formerly uninsured patients tend to have clusters of medical issues, little or no treatment or care in the past, and tend to have concommitant socioeconomic challenges. 

For patients, coverage -- and the resulting medical care -- is a great thing. For providers, it is both an opportunity and a challenge. In the above New York Times video, Maria Catalano, a Nurse Practitioner at Family Health Centers, explains: "It seems like we're seeing a lot of newly eligible Medicaid patients who have not had established healthcare in many years. It's great that they're finally having access to insurance, but it can really expand the visit and try to do a lot in one visit."

This influx of patients creates a challenge in terms of the quantity of care that needs to be provided, as well as the pressure to comply with the regulatory issues related to the Affordable Care Act. Additionally, these patients present with medical issues that need collaboration and care from several different providers. All of this adds up to interconnected challenges that can be mitigated -- if not solved -- by medical collaboration through telemedicine solutions. 

The deluge of newly insured patients under the Affordable Care Act present challenges that can only be met through medical collaboration: 

• When time-per-patient is short, and patients are presenting with multiple interconnected issues, medical collaboration -- especially the kind of efficient collaboration that happens with hybrid store-and-forward telemedicine -- becomes a must-have. 

• Medicaid demands accountability for Length of Stay and Readmissions. Medical collaboration has been proven to improve both of these metrics.
  

• The ACA makes it easier than ever to be reimbursed for telemedicine. With this infux of patients, efficient reimubrsement is essential.
  
  
• Meaningful Use of medical records is even more important under the ACA, and telemedicine-supported medical collaboration can facilitate just that. 

Maria Catalano confirms both the ways that these new ACA patients present both difficulty and gift: "We're lucky in that a lot of our patients before now weren't getting Medicaid. So now we can start getting reimbursed for the care we weren't getting paid for before if they were a no-insurance patient. But I would say the most concerning thing is -- how can we accommodate so many new patients with so many different problems, and still function at the end of the day?"

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