A South Texas employer group has made the decison to drop their PPO network and pay physicians U&C. Facilities will be paid using Medicare as a benchmark.
The rationale?: Why pay PPO access fees, (disclosed and undisclosed) when instead you can just pay providers what they get anyway? Seems to make sense.
Editor’s Note: There are two species of medical providers – doctors and hospitals. Doctors want to be paid fairly and promptly. Most hate PPO networks, insurance companies and other intermediaries who “manage” health care. They sign PPO contracts only because they want to be advertised as “preferred.” Doctors would like nothing better than to be left alone to practice medicine. Hospitals, are different. They consider PPO networks as their outside salesmen and partners. They dictate pricing while PPO intermediaries demand ” discounts” to justify their fees. Inflated and arbitrary pricing accomplishes both objectives.