The most sobering assessment of the impact of the 2010 ACA that I have read is the Annals of Internal Medicine article
The Affordable Care Act and the Future of Clinical Medicine: The Opportunities and Challenges. The authors were from the National Economic Council, the Office of Management and Budget and the Office of Health Reform in the Obama White House.
The bad news for solo practitioners and small groups:
The economic forces put in motion by the Act are likely to lead to vertical organization of providers and accelerate physician employment by hospitals and aggregation into larger physician groups.Although the American College of Physicians was roundly attacked for publishing the article in their journal, few challenged the conclusions that the ACA is likely to accelerate the decline of small private practices. I am certainly witnessing this in my region.
