highslice
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- Mar 28, 2008
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I will take that a step further (and maybe this is implied in your post) payers followed Medicare's lead and cut reimbursements by 2/3. So the docs and hospitals had to triple prices so they could get reimbursed for the cost of the tests/procedures/visits. It's a vicious circle.I agree. But Managed Care was the result not the cause of the deterioration of care.
Come with me on a trip down memory lane. Back when HC was all fee-for-service. When some doctors mainly specialists discovered the principle of ‘more’.
Like the monkey in a cage who accidentally bumps the button and drops a banana. Many doctors learned that if the purchased (leased) that diagnostic equipment they could generate a six-figure plus revenue stream.
Add hospitals to that doctor equation. Add the American patient psyche back then where they demanded unfettered care on-demand and woe to you if you didn’t jump.
Over utilization, litigation, explosion in tech and procedures, caused the Fed to explore ways to slow the bleeding by reducing Medicare reimbursements every year until the payers figured out risk and that they could shift it to providers.
And here we are today w risk based contracts.
That’s a 35-40 year over simplified summary.