Received via e-mail from newsmax: 5. Obamacare Leading to Costly Medical Consolidations As recently as 2008, 62 percent of American doctors were independent — they had their own practices. Today, that number has fallen to just 35 percent. Thats one of the consequences of the Affordable Care Act — consolidation of previously independent doctors into salaried positions within larger institutions, usually a hospital. And the consolidation is increasing healthcare costs. Scott Gottlieb, a physician and resident fellow at the American Enterprise Institute, explains the dirty little secret regarding Obamacare. Obamacare payment reforms are fashioned after 1990s-style health maintenance organizations, or HMOs, in which entities like hospitals would get a lump sum of money from Medicare (or now, Obamacare) for taking on the risk of caring for a large pool of patients, he writes in The Wall Street Journal. But right now all of these payment schemes are tilted far in favor of having hospitals pool that risk, and not looser networks of doctors. Medicare reimbursement favors hospitals over independent practices by paying more for procedures that are performed at a hospital outpatient clinic. For instance, Medicare pays $876 for a colonoscopy at a clinic compared to $402 at a private practice. A 15-minute visit to an independent doctor is reimbursed at $70, but $124 if the doctor is at a hospital outpatient clinic. This may be the same physician working out of the same office he or she always has worked out of, but the designation changes to hospital outpatient once the practice has been consolidated into a hospital system, said Devon Herrick, a senior fellow at the National Center for Policy Analysis. Also, to comply with new payment reforms, healthcare providers must control their IT infrastructure. Only hospitals, which already have their own server hub, can afford to do that, Gottlieb points out. With consolidated healthcare systems, competition is reduced, for there are fewer independent providers left to compete on prices and services. A recent study published in the Journal of the American Medical Association confirmed that consolidation raises the cost of healthcare. Between 2009 and 2012, healthcare providers owned by local hospitals had costs that were 10 percent higher per patient than practices owned by the physicians themselves, notes Kenneth Artz of The Heartland Institute. And per-patient expenditures in practices owned by multihospital systems were 20 percent higher.
Posted on: Sun, 04 Jan 2015 21:42:41 +0000
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