As the coder and credentialer for Keystone Urology Specialists in Lancaster, Pa., Mr. Reinford spoke with Becker’s ASC Review on his bold predictions for payers.
Editor’s note: This interview was edited lightly for clarity.
Question: What are your predictions for the payer market in the next five years?
Mark Reinford: I see more consolidation with the big payers. I predict Aetna, Cigna, UnitedHealth and the Blue Cross Blue Shields garnering more market share as they diversify their offerings both in the standard commercial market and their “boutique” — for lack of a better word — markets.
They will also try to corner as much through the Affordable Care Act markets as possible. I do not see much relief cost-wise for the average consumer, as the deductible/out-of-pocket amounts will rise. While I would love to see “Medicare for All,” I think we may start to see some consolidation in fee schedules in some areas moving toward single-fee schedules versus multiple-fee schedules.
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