Most healthcare providers on the front lines such as internists, chiropractors and pediatricians have been accustomed to insurers doing things to further decrease their reimbursements and their roles in healthcare, which reduced cost.
Recently, a friend of mine who is a local Doctor of Osteopathy was talking about how United set their fee schedule so low that he would only allow his PA to see these patients. He also told me about how they stopped paying him for two months because they said he was removed from their network, even though he was never notified. He is still working on being paid for services provided last January and February. While insurance companies continue to find new ways to financially harm primary care and first contact providers such as chiropractors, they are having no problem forcing up costs elsewhere in the system.
The behavior of insurers such as this, or of Horizon Omnia that makes more expensive providers appear less expensive by reducing their co payments while less expensive providers are given high deductibles to decrease their use are insane behaviors, yet they contribute to healthcare costs. Worse, they have priced us out of better plans forcing us to purchase Omnia.
Recently, it was reported that the largest healthcare systems reduced ER and hospital admissions by 19 percent. These savings were eclipsed by other costs such as Obstetrics which have increased a lot, forcing costs to rise in NJ. It is unbelievable that we are being told to believe Horizon and believe big hospital systems are trying to help us reduce costs because the data suggests otherwise, and it is time for us to wake up. Perhaps, it is time for insurance carriers to compete with Medicare. Perhaps, it is time for a single payer system.
Check out this article featured in NJ Spotlight.
HEALTHCARE COSTS CONTINUE TO RISE IN NJ, OUTPACING NATIONAL INCREASE
LILO H. STAINTON | OCTOBER 15, 2018
Although record numbers of New Jerseyans now have insurance coverage, the price of healthcare remains a major difficulty for families and small businesses
Far fewer people are being admitted to New Jersey hospitals in recent years, with improvements in medical care and a growth in less-costly outpatient options. But, with the price of inpatient care escalating by nearly 40 percent over four years, spending on this category continues to climb.
That was one of several sobering takeaways from four years worth of claims data collected by the Health Care Cost Institute, an independent research organization backed by a handful of national health insurance companies, at the request of the New Jersey Health Care Quality Institute, a nonprofit policy organization seeking to improve the state’s system of care. Linda Schwimmer, the quality institute’s president and CEO, shared the findings in a blog post late last week.