Commercial payers' acquisition sprees and direct-to-employer contracting are two of the biggest trends providers should be paying attention to as healthcare costs continue to rise and independent practices fight to maintain their autonomy.
Four surgeons expanded on why providers should be following these trends:
Question: What's one healthcare trend you feel isn't getting the attention it deserves?
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: The ever-growing list of healthcare entities being purchased by one or two insurers and adding to their ever-expanding portfolio. The only beneficiaries of this are their shareholders. Quietly, many physician groups, contracting agents and software programs belonging to these large companies have been appearing. Their presence is even felt in the halls of government, evident in very large contracts signed by CMS and even the portal the Coronavirus Aid, Relief and Economic Security Act is run through. It's almost as if no one lived through 2008. "Too big to fail" should be on the top of everyone's mind. Certainly the lack of independence of even our governmental agencies from these companies is truly a turn for the worse.
Nicholas Grosso, MD. The Centers for Advanced Orthopaedics (Bethesda, Md.): I believe direct-to-provider contracting between employers and physician practices should be getting more attention as the cost of healthcare continues to rise. Employers are feeling this increase and have no choice but to pass costs down to employees. As recruiting and retaining talent remains a challenge across industries, employers can save by contracting directly with providers, which will be more attractive to employees.
Ehsan Jazini, MD. Virginia Spine Institute (Reston): Consolidation across payers and service providers can streamline the business of healthcare and save costs but also limit access and innovation and ultimately the progress of healthcare across the U.S. Competition is key to advancing any field, and healthcare is no different. The monopoly of healthcare by large corporate insurance companies is a dangerous trend that must be evaluated and limits imposed.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): By and large the attention towards staffing issues, especially in the operating rooms, has been an additional hurdle of late. Between the half dozen surge contentions and subsequent fall out of lassitude, the ability for hospital systems to properly staff and return to some normalcy in practice is affected. Albeit urgent and emergent care has not faltered, there is measurable lagging in both nursing an other ancillary services from the pre-COVID business model. This could represent the new norm.