Litigation, Lawsuits, & Patient Care Disruption | Donald Saelinger Lawsuit

19 Dec

Is it the ultimate solution for increasing quality and reducing the cost of healthcare for Americans?

Will it result in litigation, lawsuits, and patient care disruption?

Healthcare reform (Affordable Care Act) encourages providers to create larger delivery organizations that can coordinate care in pursuit of greater quality and efficiency at less cost. In most cities across America, hospitals are merging together to form large systems. Expanded hospital networks are purchasing physician practices at an alarming rate.

According to a recent Accenture analysis of American Medical Association and MGMA data, 64% of American physicians will be employed by a hospital/physician integrated delivery system  by the end of 2012.  In year 2000, the vast majority of American physicians worked independently in groups, not affiliated financially with a hospital system. This trend continues to pick up steam so that at the end of the day, most metropolitan areas will have large integrated physician/hospital systems competing with other similar systems in its market based on cost and quality. In prior years, the three components of the delivery system (health plans, hospitals, and physician groups) competed with one another based on cost and quality.

Currently, the physician-hospital integration process however has actually increased the cost of care to patients, health plans, Medicare and Medicaid. When physicians move from independent practice to hospital employment, frequently practicing from the same site with the same staff, bills for routine services are significantly higher than those charged by the formerly independent physicians. As a result, the same service performed in the same location by the same doctor can cost more than double what it did before the hospital acquired the practice. Prices increase for no other reason than the sign on the door is changed. Frequently Medicare and other insurance plans pay hospitals more than independent doctors. Usually, this also results in higher out-of-pocket co-pays for patients.

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