We have heard this many times about the future of the primary care doctor with a small practice and like anything else out there today, the big corporations seem to be closing in here as well.  Overhead can be absorbed much easier when there’s a lot of areas to spread it out over versus what a small practice has.  Last year this article came out about the average cost that is needed today for taking insurance.

Health Insurance Paper Work Costs Doctors an Average of $83k a Year

This is a built in cost and I might say since last year is probably on the rise just due to the complexities of what is required anymore as the algorithmic formulas for reimbursement and red tape multiplies.  Sure there are some trade offs that make some items more efficient, such as electronic claims and clearinghouses but they are only tools that go towards the over all reimbursement process.  Doctors are presented with new updated contract all the time and it’s hard to see where the cuts will play out all the time as it is complicated and when large insurers have spent many computer and man hours to keep their costs and reimbursement levels to where profits are made in each area of their operation, the individual doctors really don’t stand much of a chance for argument purposes as with formulas for profit today can’t use simple math to get to a realistic level of accuracy.  Here’s a good example of a mass roll out of new contracts.  This group of course is the king of analytics with the short pay for 15 years with their Optum/Ingenix group for out of network charges. 

United Healthcare Preparing to Roll Out New Contracts To Pay Doctors& Hospitals For Meeting Goals and Keeping Costs Down– Plenty of Subsidiaries to Provide Some of the Technology And/Or Products & Generate Income–Subsidiary Watch

One other gray area today is knowing who you do business with as insurance companies are buying up a lot of other related and non related companies and one day I wonder when someone will unravel all of this as far as fair competition as with data sharing today one subsidiary could have absolute knowledge as to what is going on with another subsidiary and come back in and sell services or products from another subsidiary.  How can doctors or even patients for this matter know where their dollars spend even end up and to what corporate conglomerate do the profit dollars go? 

Subsidiary Watch-Corporate Conglomerate Insurers Reduce Compensation Contracts Using One Subsidiary Then Market Same MDs With Another Subsidiary in Health IT

Those that control the code control the world and that came a higher source than the Medical Quack but is is true and we are all subject to this as the business algorithms have moved the money around and corporations have profited.  Sometimes this is a slow process and it works in the background so you can’t see what’s really going on but the masterminds of the algorithms design it that way.  If you want a good parallel pay attention to the market news of late…the algorithms are busy at work. 

Doctors Going Broke–You Can’t Even Give a Practice Away–Only Folks Buying Them Are Hospitals and Insurance Companies As It Relates to Reimbursement and/or Profits

When new contracts come out so does new software that is created and dumped on the consumer or the physicians to learn how to work with, it’s been going on for years and sure some of this is needed, but not all.  When your sick do you want to have to open Quicken Health or some other program like this so you can figure out where you can go, what exactly is going to be paid or not paid and then still end up on the short end of the stick as the contract changes mid stream?   Kind of hits patients when they least want to file through all of this but it goes on and multiplies every day so watch for more new web software to help doctors and patients figure out the complexities of health insurance, we don’t get a break but rather end up spending more time on finding out why we don’t get we need so much of the time.  Insurers want perfect files on all of us.

Attack of the Killer Algorithms-Occupy Wall Street Part 4 Health Insurance Style - One More App For Folks Who Are Tired of Flawed Algorithms That Require A Ton of Work and Research Time To Create “Perfect” Data Files for Insurers And Others Analytics Processes

Hospitalists, Peer Committees and Utilization Struggle to Comprehend United HealthCare Algorithms

Well after reading some of this is it any secret why the family practice is going away?  It’s all about the money and this area of small business in the US is not getting much help from the government. 
The cost and reimbursement algorithms rule in more place than just the market.

As a matter of fact even the demonstrators didn’t know why they were there with the Occupy movement but I have said this many times and made the post back in October of 2011, the Occupy movement has it’s roots right in the Attacks of the Killer Algorithms as formulas running behind the scenes arrive to either take your money, ethics and sometimes even both.  BD

Occupying Wall Street–It’s All About the “Attack of the Killer Algorithms”–The Unfair and Marketing Exploit of Ethics Using Math–This Could be a Subject for Michael Moore to Explore and Document In a Movie

WALTHAM, MA – The newest monthly Physician Wellbeing Index from online medical learning network QuantiaMD shows that 26 percent of primary care physicians report poor financial health.

According to QuantiaMD this trend – as well as a lack of incentives and other professional challenges – is resulting in many PCPs moving away from the practice of primary care, even as the Affordable Care Act places added emphasis on prevention and primary care.

Key findings of the latest Physician Wellbeing Index of those physicians in financial difficulty include:

81 percent of physician practice owners report profits are down from last year;

43 percent of physician practice owners are having trouble covering their costs;

80 percent said a decrease in reimbursements is the top negative financial impact to their practices, while 71 percent also cited a rise in operating costs;

49 percent of employed primary care physicians have not had a salary increase in one to two years; and

18 percent of primary care physicians have experienced salary cuts.



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