Jeff Goldsmith does an about face: vertical integration in health care doesn’t work.
Study: Which matters more for ER spending – price increases or upcoding? Next study should examine the IQ of the insurers who pay the ER fees.
The next president of Argentina may be a libertarian.
Thanks for posting on the little-known (but profound) effects of up-coding on the medical spend.
We could have the most pristine Medicare-for-all program that still did not save us a nickel– because providers would find the highly-paid niches in the schedule.
You imply that insurers should fight back against upcoding, and are fools if they don’t.
Fighting each individual upcoded claim would be very costly in time and staff…simpler to just pay the larger claims, and go back to the employer with higher premiums.
George Halvorson (ex-head of Kaiser) was in charge of claims at a Midwest insurer in earlier years. He once went to a hospital CEO and asked him why claim payments kept going up. The CEO said, “We can outsmart any new fee schedule in a few weeks. For a really tough fee schedule, it takes maybe 6 months.”