Witch Doctors & Palm Readers

Managed Care Executive

We just can’t think anything other than they are as stupid as stupid gets…….……

By Molly Mulebriar

Patrick Rooney is the Godfather of Cost Plus Insurance. Rooney acknowledged that hospitals may need to charge more than Medicare will pay,but contended that authoritative research showed that Medicare plus 25 percent is the reasonable amount for hospitals to charge.  J Patrick Rooney (1927 – 2008)

We now know many PPO contracts, even after significant “discounts”, reimburse 260%, 400% or more of Medicare allowable. Medical costs continue to escalate because most of us continue to agree to pay our health claims through secretive managed care contracts we cannot see.

When we see a plan sponsor continue to cling to managed care contracts they can’t see, audit, or question and costs them much more money than they should be paying for health care, we just can’t think anything other than they are as stupid as stupid gets.

Cost Plus / Reference Based Pricing provides a common sense approach. It’s proven, sustainable and defensible.

The golden age of managed care (PPO’s) will soon be a memory unless stupid continues to be an epidemic plague treated by witch doctors and palm readers.

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