The insurers say their purchase of medical practices is a step towards what is called value-based care, with both the insurer and the doctor paying a fixed fee to care for an individual patient. The fixed payment acts as a financial incentive to keep patients healthy, provide better access to early care, and reduce hospital admissions and costly visits to specialists.
Companies say they prefer flat fees to the existing system that pays doctors and hospitals for every test and treatment, encouraging doctors to order too many procedures.
Under Medicare Advantage, doctors often share profits with insurers if they assume the financial risk of a patient’s care, earning more if they can save on treatment. Instead of receiving a few hundred dollars for an office visit, primary care physicians can be paid up to $14,000 a year to manage a single patient.
But experts warn that such major acquisitions threaten the personal nature of the doctor-patient relationship, especially if the parent company has the power to dictate limits on services from the first office visit to extended hospital stays. Once registered, these new customers can be directed to related business chains, such as a CVS pharmacy or Amazon’s online pharmacy.
UnitedHealth Group is a sprawling example of consolidated services. He owns the leading insurer with nearly 50 million customers in the United States and oversees its growing subsidiary, Optum, which has bought up doctor networks and medical sites. Optum can refer patients from any of its approximately 70,000 physicians to one of its urgent care or surgery centers.
Sen. Elizabeth Warren, Democrat of Massachusetts, is urging the Federal Trade Commission to take a closer look at some of these big deals, which regulators have so far not blocked on antitrust grounds. “I fear that the acquisition of thousands of independent providers by a few massive healthcare mega-conglomerates will reduce competition locally or nationally, hurting patients and increasing healthcare costs,” he said. – she wrote to regulators in March.
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