Golden Rule of Reimbursements

There are grumblings in Vermont about the disparity of payment to independent doctors versus hospital based doctors:

In 2015, commercial insurance companies reimbursed independent doctors about $100 for a typical primary care visit and paid academic medical centers $168 for that same service, according to data the Green Mountain Care Board’s staff presented at the meeting.

That’s a 68% pay raise, most of which goes to the hospitals, by the way.  The brilliant cracker jacks on the Green Mountain Care Board are trying to figure a way to fix this.  Their only answer is either to strong arm the hospitals via the budget process or make everyone join their “all-payer” model.  As one member said:

“In a perfect world we would let the all-payer model solve this problem.”

Are you kidding me?

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The hospitals rule because they have the power.  The medical golden rule is that those who have the gold make the reimbursement rules. And the hospitals have the gold. Independent doctors who continue to compete with this will always lose.  In a perfect world, we need to leave the insurers behind and do direct primary care and NOT an all-payer model, which is more of the same.

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