Why physicians are concerned about the pending insurance megamegers — 4 thoughts

The healthcare industry is undergoing consolidation and the insurance industry is no exception. However, as competition dwindles in the market, physicians are concerned how the payer consolidation will detract from quality care, according to an article Joseph Valenti, MD, published in Forbes.

Here are four thoughts from a Physicians Foundation board member:

1. To squash concerns over minimal competition, various payers have vowed to divest plans in select areas. However, Dr. Valenti said if history is any indication, another leading insurance company will buy these plans or the "market will be left to Blue Cross Blue Shield, leaving consumers with even less choice."

2. Payers often give customers the choice of physicians based on the costs associated with that physician. With cost being the overall deciding factor, many physicians worry healthcare's quality will diminish.

3. As reimbursement goes down, physicians try to offset these losses by tacking on more patients. Therefore, providers spend less time with patients, detracting from the physician-patient relationship.

4. If providers do not drop patients with costly conditions, many payers will simply force that physician out of their network.

More articles on coding & billing:
Aetna to pull out of 11 ACA exchanges; expects losses reaching $300M: 5 things to know
Kaiser invests in Health Catalyst: 4 things to know
CMS to update PACE program for first time in decade: 4 thoughts

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