The Not So Humorous Unintended Consequence of Healthcare Reform is Monopoly

CheckThe administrator's voice wavered as I picked up the phone.  He was calling about the nursing home patient that I admitted the day before.  While normally forthright, I could feel the discomfort in his tone as he danced around the issue.  The patient's insurer had called.  Apparently they made an "arrangement" with the Mega ACO owned by the latest consolidation of Goliath health systems.  They wanted my patient transferred to another doctor.  Apparently the insurer now required all it's patients to be seen by only medical group physicians. The administrator was almost whispering now.The truth is, if it was up to me, I would have you see all our patient's!The medical group doctor hardly ever rounded.  She was almost never available for urgent calls.  Her patients were transferred out to the hospital at the drop of a hat.  Yet, incredibly, she was managing three quarters of the nursing home population.   But the medical group physician had one advantage that trumped clinical quality or even cost of care.  She was measurable.  Her every move was recorded in an electronic medical system that could be beamed into the greedy hands of administrators, case managers, and insurers at whim.  This data could be analyzed and assessed, and spit back at her with ultimatums and extracted promises.We sat silently on the phone at a loss for words.  The nursing home could not dare damage the fickle relationship with the ...
Source: In My Humble Opinion - Category: Primary Care Authors: Source Type: blogs