MedPage Today February 19, 2022
— Do they have a shot?
The American healthcare system has unique financial hydraulics, a sophisticated and opaque “Game” that depends on self-insured employers to make and keep providers whole for the perceived “underfunding” by public payers like Medicaid and Medicare. Both doctors and hospitals are completely dependent on the financial margin derived from commercial insurance. RAND studies show that on average, private purchasers are paying approximately two and a half times more than Medicare rates for hospital care (even more relative to Medicare for hospital outpatient services).
The COVID-19 pandemic has only intensified this dynamic. Despite massive federal spending, employers fear that an overwhelmed health system may look to them to solve the financial pressures created by the pandemic...
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