The problem consolidation among hospitals and doctors with the affordable care act Essay
The problem consolidation among hospitals and doctors with the affordable care act, 484 words essay example
AFFORDABLE CARE ACT- BOON OR BANE
The per capita spending on the healthcare industry in U.S is twice when compared to other industrialized nations. Institute of Medicine reports that approximately $750 billion was wasteful spending this equates to 30% of overall spending on healthcare services.
Healthcare costs occupies a major share in federal budget, yet not able to maximize the quality of healthcare delivered for the amount spent. The health policy makers are pondering over the best possible way to rationing healthcare resources.
The estimated population covered under the affordable care act is 30 million to 34 million people. It is explicit that the main emphasis is on coverage but not care.
The problem consolidation among hospitals and doctors with the affordable care act.
Consolidation refers to merging of two hospitals or health care systems to acquiring of a group of physicians by hospital forming Accountable care organizations (ACO's), this integrated multi-hospital model is aimed to minimize the unnecessary spending without compromising quality care. In other words, we can call it as one-stop stopping.
Hospitals are precipitously buying physician practices to create such tremendously integrated health systems. As a result, In Texas 29 percent of physicians working in solo private practices has a higher number of physicians working in solo private practices than most states. Nationally, only 17 percent of physicians practice independently today, from 57 percent in 2000.
generally speaking, when hospitals consolidate the insurers eventually end up paying more in reimbursements. On the contrary, In the fee-for-service system, the insurers can negotiate prices with healthcare providers, but this may reduce the services available to patients under the health plan, hence did not led to true integration.
Nationwide, payments to hospitals on behalf of the privately insured are an estimated 3% higher as a result of consolidation, according to a 2012 report .
However, the downside of this transformation is rise in market power causing competition among providers thereby negotiating high reimbursements with insurers. This market monopolization means providers dictating the cost which can drive up already costly insurance even more expensive which is not in favor of patient.
So, what is the actual problem here? Well, according to a study conducted among multi-hospital model and physician-owned care center in California. Results shows the health care costs are 20% higher in multi-hospital model.
Furthermore, the increase in price of care and hospital consolidation might limit the patient choice of both service and treatments available. Patients are unaware of cost-effectiveness of the treatment they are getting for the amount they paid.
More people with healthcare means more patients to hospitals, It sounds as unreasonable as it is but the fact is one may have to wait longer than it is now to make an appointment with physician, projections anticipate a critical shortage of workforce between 91,500 to 130,000 physicians by 2020
The monopoly power and their potential effect on costs. Be that as it may, policymakers ought to likewise consider the disadvantages that consolidation of multiple-hospital integration might create.