David vs Goliath: The Healthcare Monopoly
Also: the threat of reducing reimbursements; next in line; fixing healthcare; and the changing price tag
Monopolies in America are not new. This country has witnessed monopolies in sectors from commercial steel to telephone services. Imagine having just one internet service provider available to you in your community. The consumer loses the power of choice. Limited-to-no choice for consumers means service providers have no incentive to maximize quality or to establish competitive prices. It turns out that more hospital systems and insurers are acting more like monopolies than health care providers.
Some communities are witnessing the effects of health system and insurer monopolies which is resulting in limited choices and increased consumer prices. Over the years, behemoth corporate entities have been formed from multiple mergers. This consolidation of power had a top priority: maximize profits for executives and shareholders. The priority was not to maximize healthcare at affordable prices. What is the impact of power consolidation on real families? In 2021, annual premiums for family coverage via an employer-sponsored insurance plan were $22,221. Surely this cannot be sustainable. However, once power has been consolidated on these large scales, history has proven that it is difficult to break up. Check out this informative piece regarding this topic.
Emergency Medicine
Keeping EDs open
There is a tug-of-war between EM contract management groups and insurance payors: how much to pay for services. This battle is making the EM patient a casualty. Read how 2020 The No Surprises Act has impacted this conflict.
Next patient, please
A July 2023 JAMA Network Open article examined how “next patient to be seen” decisions were made. One would think that acuity and time of presentation are the sole inputs for the order of evaluation. However, this article discusses disparities that were identified in a study of over 300,000 patients.
How many EPs in 8 years?
The Bureau of Labor Statistics predicts a 3.3% percent increase in emergency physician employment change by 2031. Family practice is predicted to have the same rate of growth. Psychiatrist employment is predicted to increase by 8.7%.
House of Medicine
Healthcare in10 years from now
It’s no secret that financing healthcare in America is seriously challenged. Multiple effects of the pandemic further strained the market. In this post pandemic period, health care leaders have been evaluating how to redesign their healthcare delivery models. Multiple ideas are being explored. Some of these include using technology to extend healthcare virtual touchpoints in the patient home, and to export traditional hospital campus services into outpatient locales. Redesigning healthcare is a tall order, but it appears that business as usual will not survive the next 10 years. You can expect for EDs to experience some degree of design change.
Hospitals, health systems, and more
Different prices for different payers
Imagine going to Morton’s steakhouse and asking how much the 10 oz filet costs, and the waiter tells you that it depends on how much money you make. Check out this quick read that discussed different prices for the same procedure depending on who the payer is.
An uphill crawl for health systems
Moody’s warns that healthcare cashflows will lag for years trying to reach pre-pandemic levels. Moody’s further predicts that salaries for permanent workers will continue to rise, as will supply costs. Will your salary rise?
The Good Stuff
Increasing access to healthcare seems to have a chance. The Bureau of Labor Statistics predicts that the NP force will grow by over 45% in the next 8 years. There’s lots of debate about scope of practice by NPs & PAs. There is also a big access to care problem in this country paired with a physician shortage problem. I believe more patients will have an increased opportunity to see a medical provider and receive quality care in the next 8 years.
Read about Kevin Lohenry, a PA and Navy veteran with a colorful history. Kevin has been a key contributor to the PA profession. Thank you for giving back, Kevin!
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