What happens to a BUCA Buck when the City of Harlingen pays their health insurance bill? Where does it go and as it travels through the medical industrial complex, and how much of its value is ultimately returned to plan members?
BUCA Bucks go to “pay for medical coding, insurance networks, adjudication, delays, denials, rate negotiation, sales/brokers/agents, the cost of a third party EMR, skyscrapers in every major city in the US, and the hundreds of thousands of employees that work at the insurance company and hospital/practice before a claim is ever paid.” – Monte Jennings
In addition, transaction fees of all sorts are charged by third party intermediaries as BUCA Bucks begin their journey to provider bank accounts. That process takes weeks and months before plan members and their medical provider realize any value whatsoever.
Recognizing American health care finance is inefficient and wasteful more plan sponsors are cutting out the middlemen and dealing directly with the medical community.
The City of Harlingen would be wise to do the same. Local physicians would welcome the change and support it. The two hospitals in town would join in too, benefiting all stakeholders. A Community Health Plan would retain the full value of each former BUCA Buck. It’s journey to provider bank accounts would take seconds, not weeks and months.
Will the city do this? Not without the political clout of the local provider community. They have the power to change health care finance. But will they?
