Re: Insurers owning providers

[Guest guest]

why is it OK for insurers to own practices, thereby essentially selling medical care, when it's not legal for me to " sell insurance " ?

Annie

 

Just read an article about insurers moving into buying practices and clinics:  http://www.ama-assn.org/amednews/2011/05/16/bil20516.htm

Here are 3 quotes--- note the last one.  Makes me cringe. " It's a tangled web of reasons why it's happening, " said Gorman, CEO of Gorman Health Group, a managed care consultant who recently advised several insurers that opened clinics. Right now, Gorman said, plans are worrying not so much about making money but about controlling the spending of money.

Gorman said the insurers are following a similar philosophy to that of hospitals, which recently stepped up their purchases of clinics and primary care practices.

" When you own the facility and you own the people who work there, it's a lot easier to shape it in a way that conforms to the economic necessities of the local market, " he said.

-- Annie Skaggssville, KY

[Guest guest]

"When you own the facility and you own the people who work there..." Ick. Purveyors of flesh. Ours. Chilling. why is it OK for insurers to own practices, thereby essentially selling medical care, when it's not legal for me to "sell insurance"?Annie Just read an article about insurers moving into buying practices and clinics: http://www.ama-assn.org/amednews/2011/05/16/bil20516.htmHere are 3 quotes--- note the last one. Makes me cringe."It's a tangled web of reasons why it's happening," said Gorman, CEO of Gorman Health Group, a managed care consultant who recently advised several insurers that opened clinics. Right now, Gorman said, plans are worrying not so much about making money but about controlling the spending of money.Gorman said the insurers are following a similar philosophy to that of hospitals, which recently stepped up their purchases of clinics and primary care practices."When you own the facility and you own the people who work there, it's a lot easier to shape it in a way that conforms to the economic necessities of the local market," he said.-- Annie Skaggssville, KY

[Guest guest]

I thought most states had laws that clearly laid out the idea that ONLY a Licensed Practioner can OWN a Medical Practice. I as my wife the licensed doctor's spouse am NOT allowed to own even a single share in our NYS Registered corporation....

But all that being said, I have actually sort of jokingly advocated for this. As employees of the managed care company Doctors can No Longer be Sued.... Also, if they want to control the care and over see it so much then let them employ you guys and have to find a way to provide retirement, healthcare, disability, CME expenses classes and travel, time off, vacation, and let them take ALL the heat for any of their terrible care management choices instead of you guys.... The joke is you all really are employees right now already if you are on their contracts, terms and conditions. I as a youth hockey official have more real honest independent Private Contractor status by the rules as laid out by the IRS for ruling on whether or not someone really is a private contractor or employee. My Call on the Ice is FINAL..... If I do call something a foul or I let it go as within the boundaries of fairplay or acceptable conduct, once I have ruled or NOT ruled

and play continues, tough, that is is, my word is final. My calls on the ice can not be challenged or over turned.... Where as you docs have these carriers acting as an employer by overseeing controlling and influencing, over seeing your professional judgement. Most of the time that alone should be enough to rule you an employee instead of as a private contractor....

I promise you once doctors are employees and therefore not private contractors and therefore they could organize and bargin collectively and make big pushes to see the books of the for profit employer so as to have verifiable information from which to negotiate from.... These carriers will quickly see just how expensive it is to have to absorb all the extra time and costs associated with their at the moment uncompensated mandated care like call backs, Rx refills, paperwork, prior auths... I personal feel it would be the best crash course in medical economics these bastards could even hang themselves with.... Let them have to purchase supplies, schedule coverage, purchase and maintain EMR's hardware and networks, teach front desk staff how to use it... and let them try to get docs to hurry up and keep seeing 35-40 patients a day once someone is on salary.... because denying care and not getting the patient in for treatment is actually now the largest

cost savings tool in general so having productivity as a measure no longer makes good sense... They don't want patients coming in and using up staff time and supplies... Now they have control over the ultimate road block and barriers to care, the schedule and staff numbers themselves...

Let 'em do it, it will quickly freak them out as they attempt to herb you cats....

To: Sent: Tue, May 17, 2011 12:04:51 AMSubject: Re: Insurers "owning" providers

"When you own the facility and you own the people who work there..." Ick. Purveyors of flesh. Ours.

Chilling.

why is it OK for insurers to own practices, thereby essentially selling medical care, when it's not legal for me to "sell insurance"?

Annie

Just read an article about insurers moving into buying practices and clinics: http://www.ama-assn.org/amednews/2011/05/16/bil20516.htmHere are 3 quotes--- note the last one. Makes me cringe."It's a tangled web of reasons why it's happening," said Gorman, CEO of Gorman Health Group, a managed care consultant who recently advised several insurers that opened clinics. Right now, Gorman said, plans are worrying not so much about making money but about controlling the spending of money.

Gorman said the insurers are following a similar philosophy to that of hospitals, which recently stepped up their purchases of clinics and primary care practices.

"When you own the facility and you own the people who work there, it's a lot easier to shape it in a way that conforms to the economic necessities of the local market," he said.

-- Annie Skaggssville, KY

[Guest guest]



Think only in Calif is there a restriction on who can own a doc group.

Insurer BCBS owned a conglomerate of 3 medical groups my area.

Before that, an HMO owned a multisite multispeciality group as well (I worked for that one for 6 years).

It mainly falls apart because pts want to go outside the implied network of docs, and the docs end up either being overworked or constantly in conflict with pts on care.

My experience in Western PA

Matt

Re: Insurers "owning" providers

"When you own the facility and you own the people who work there..." Ick. Purveyors of flesh. Ours.

Chilling.

why is it OK for insurers to own practices, thereby essentially selling medical care, when it's not legal for me to "sell insurance"?

Annie

Just read an article about insurers moving into buying practices and clinics: http://www.ama-assn.org/amednews/2011/05/16/bil20516.htmHere are 3 quotes--- note the last one. Makes me cringe."It's a tangled web of reasons why it's happening," said Gorman, CEO of Gorman Health Group, a managed care consultant who recently advised several insurers that opened clinics. Right now, Gorman said, plans are worrying not so much about making money but about controlling the spending of money.

Gorman said the insurers are following a similar philosophy to that of hospitals, which recently stepped up their purchases of clinics and primary care practices.

"When you own the facility and you own the people who work there, it's a lot easier to shape it in a way that conforms to the economic necessities of the local market," he said.

-- Annie Skaggssville, KY

[Guest guest]



Oh, and you CAN be sued -- not only that, as an employed doc, the employer decides if you can fight or settle...

Re: Insurers "owning" providers

"When you own the facility and you own the people who work there..." Ick. Purveyors of flesh. Ours.

Chilling.

why is it OK for insurers to own practices, thereby essentially selling medical care, when it's not legal for me to "sell insurance"?

Annie

Just read an article about insurers moving into buying practices and clinics: http://www.ama-assn.org/amednews/2011/05/16/bil20516.htmHere are 3 quotes--- note the last one. Makes me cringe."It's a tangled web of reasons why it's happening," said Gorman, CEO of Gorman Health Group, a managed care consultant who recently advised several insurers that opened clinics. Right now, Gorman said, plans are worrying not so much about making money but about controlling the spending of money.

Gorman said the insurers are following a similar philosophy to that of hospitals, which recently stepped up their purchases of clinics and primary care practices.

"When you own the facility and you own the people who work there, it's a lot easier to shape it in a way that conforms to the economic necessities of the local market," he said.

-- Annie Skaggssville, KY

[Guest guest]

Good one Annie!

~ Pamela

>

> >

> >

> > Just read an article about insurers moving into buying practices and

> > clinics: http://www.ama-assn.org/amednews/2011/05/16/bil20516.htm

> >

> > Here are 3 quotes--- note the last one. Makes me cringe.

> >

> >

> > " It's a tangled web of reasons why it's happening, " said Gorman, CEO

> > of Gorman Health Group, a managed care consultant who recently advised

> > several insurers that opened clinics. Right now, Gorman said, plans are

> > worrying not so much about making money but about controlling the spending

> > of money.

> >

> > Gorman said the insurers are following a similar philosophy to that of

> > hospitals, which recently stepped up their purchases of clinics and primary

> > care practices.

> >

> >

> > " When you own the facility and you own the people who work there, it's a

> > lot easier to shape it in a way that conforms to the economic necessities of

> > the local market, " he said.

> >

> >

> >

>

>

>

> --

> Annie Skaggs

> sville, KY

>