Why would any provider want to be in-network if they know they will always get more than what a plan pays?
“With this new rule, providers are not punished for failing to contract with payers. Payers are punished for not contracting with providers.”
“This puts all of the negotiation power in the hands of the provider. They know they can leave the “networking table” without a deal and collect their lump of flesh later.”
“The payer, however, now is desperate to get a contract signed – and will sign a deal, no matter how abusive – to avoid the punishments they will suffer when they dare to allow a provider to be OON.”
– Ron Peck
See article here – I Hate Surprises
FROM PHYSICIAN
Providers here obviously means freestanding ERs and hospital systems and PE backed supergroups. Independent docs are struggling with cash flow and will not have time and labor to arbitrate if there are any independent docs left!
