By Craig Gottwals
“While hospitals and insurers are milking employers for two to six times Medicare every chance they get, doctors get the stuffing kicked from them in the insured market. “
Cigna pays them 84% of Medicare:
UHC? Not all that different.:
If you consume an appreciable amount of my posts, you know I spend much time lambasting hospital pricing as it averages 254% of Medicare and is one of the most wretched, misunderstood, and manipulative elements of U.S. healthcare. It is what we attack and largely rectify with reference-based pricing (RBP).
But there is a flip side to RBP that I don’t spend enough time touting.
Or maybe I should start calling it DCP – (Doctor Centric Pricing)?
While hospitals and insurers are milking employers for two to six times Medicare every chance they get, doctors get the stuffing kicked from them in the insured market. Cigna pays them 84% of Medicare. UHC? Not all that different.
So, when we come along and agree to pay physicians 125% or even 140% of Medicare for their services? Well, as you can imagine, they often rejoice at the idea of it. And by the way, we’re going to pay you faster and with less red tape.
It is a beautiful thing.
I love when the team explains it to a new doctor’s office and they respond with something like, “What’s this plan called again? Can we do this?”
Yeah, you can, and you should. Please just don’t sell your practice (and soul) to your local hospital behemoth because they don’t feel all that different about you than the insurers do. They just want you to make sure you refer surgeries to them. ONLY them.
Hat tip to the fine folks at PriceMedic for the data.
