Thank you for covering such an important issue. I'm a practicing ER physician and I'm horrified everyday at the unsafe way we're forced to practice medicine nowadays due to PE not willing to staff appropriately in order to maximize profits. Doctors are doing 2x the amount of work, taking all of the liability, seeing pts being actively harmed by these practices, and we're the ones getting pay and benefits cuts as execs continue to profit year over year. We all need to wake up. This is not the way to continue for our own sanity and well being as well as for all of our patients safety. I'm so upset at the state of American healthcare. The worst part is patients continue to pay higher and higher premiums, all the while being blind to what's going on behind the scenes. More people need to speak out!
Open a private practice. When I was young, doctors had OFFICES, sometimes in their own homes. The reason this continues is because doctors allow it to.
Private equity is funding a number of management companies in my state to aggressively purchase cardiology practices and ambulatory service centers that do outpatient cardiology procedures. I’m seeing some scary behavior driven by profit that is not in the best interest of patients. They are exploiting a trend where many payors are encouraging outpatient cardiology procedures to be done in an ambulatory surgery center setting versus a hospital to lower costs. There are A LOT OF private practice cardiologists chasing this money by selling their practices and/or scrambling to build and open ambulatory surgery centers with the intent to sell to private equity.
Dr. Bricker: Thank you for bringing this issue to light. One item you mention in your talk is the 'Surprise Bill' issue. It should be pointed out the EMTALA (the Emergency Medical Treatment and Labor Act 'having a baby Labor') was passed in 1986 to address this issue. The problem is, no one seems to know about it. The specialist you mention in your talk are Hospital based. We refer to them as R.A.P.E. (Radiology, Anesthesiology, Pathology, and ER). Most of the issues we see, as Patient Advocates, come about as a result of an ER visit. While they may be 'Out-of-Network', EMTALA and its accompanying 'Lay Person Rule' were designed so these RAPE physicians are treated as 'in-network' by your insurance company, regardless of their contractual affiliation. If you are going in for an elective surgery, a price can be negotiated with the Anesthesiologist, prior to surgery. I welcome the opportunity to educate anyone on this issue and keep it up. Your work is very beneficial!
They -hospitals and insurance companies- also are buying primary care physicians (PCP)and turning them into urgent care facilities so they can Bill higher fees. Causes a lack of PCP
Thank you for watching and for your comment. Maybe not, but Here’s a video about where I received a radiologist reading fee for $4,400+. ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-wCKk8LFwt8s.html
@@ahealthcarez WOW. I'm a radiologist and we get $5.00 for an xray and $20 for a CT. I also used to work for Envision and was fired for putting patient care above profits. So glad to see that they are bankrupt now.
Thank you covering this issue I have been approached by a private equity company summit partners (management company is alpine) to buy my primary care practices. While an enticing offer, the fact that a hedgefund would own the practice scared me from going any further. I am an avid investor in the stock market so I see both sides. But in healthcare this is not the way to go, since it will be putting patients lives in harms way financial/physicially.
Thank you, Dr H. You deserve to be recognized for putting the values of our profession over your own financial interests. Running a private practice has become tremendously challenging, and I hope you feel fulfillment in knowing that you’re the type of physician that makes the rest of us proud to be doctors.
Thank you for sharing! I see both sides. On one hand, you don’t want profits to determine patient care. That would be a huge disaster. On the other hand, most physicians don’t understand business as much as they think they do which drives up administration cost. Coding, billing, EHRs and revenue are specialized skills. I’d like to see data on patient outcomes CPOM states vs Non CPOM states.
It does not matter any longer if you are hospital employed or private equity backed as both models ultimately deal with insurance and nigotusted contracts. The corporate practice of medicine law is redundant in practice now. Hospital groups can just charge x3-4 and private equity is stepping in to consolidate the remaining ambulatory settings to deliver more efficient care at lower price. Neither options are health for physician autonomy.
I have seen first hand the way doctors have changed the way they practice everytime a private practice sold to a hospital or equity corporation i stopped going to them.
Well, Dr. Bricker, this is one of the most alarming videos you've made. So, as a patient, how do we find out if our physician or health care clinic is owned by one of these private equity firms? After all, we have a right to know if the physician whom we are entrusting with our lives has a conflict of interest.
CPOM is so interesting. On one hand it protects the public from corporate influence on medical services, but on the other, it limits the development of medical practices as a business by hindering its internal entrepreneurial structure. Either way, the government is making more money at the end AND insuring the availability of more jobs for tax payers in their territories. USA!! I love it.
Thank you for the video! I hear this a lot... "How do these big companies do it without being a MD? Especially in California, for example. Regarding the "New" entity/Practice, wouldn't they have a hard time getting the payor agreements? Or, is the sale of the existing practice simply split into 2 parts; assets and clinical operations? I have heard that insurance companies are getting tight on adding or even replacing names on their payor agreements. And are you saying that the fact there is a sale of some sort (assets) brings them too close to the providers compared to a traditional management company that doesn't own any of their assets? Thanks again!
Great questions. First question, No. Second question, Yes. Different from management agreement in that take over ownership of practice and employ the nurses/staff. Thank you for watching and for your questions.
Great question. Goes into effect 1/1/2022. We shall see. Depends on what comes out of the provider-insurance arbitration process. Thank you for watching.
Stark Laws made most docs afraid to so much as buy an MRI machine for a neurosurgical practice (for one example): due to fear of prosecution for self-referral. So then, how the heck is this workaround available to incestuous insurance/payvider/PE-owned-vertically integrated medical Amazons? Finally, why hasn't an entrepreneurial workaround emerged to empower and enrich the only necessary component in every single medical transaction (the doc, not the VC Fund Manager)?
@Praisethesunson 3PP has monetized promises of future performance by non-obligared parties (licensed medical pros). Like Airbnb empowered owners of underlying asset to monetize their own "potential energy", so too could entrepreneurial medical professionals to monetize their own promised future performance. Not for nothing, the cost savings clawed back from 3PP middlemen would enrich buyers and sellers of actual medical care.
@@NANA-nd1kq Middlemen is how capital seizes control over the medical system. If a PE came in and directly disempowered medical staff into cogs for maximum profit extraction. The poors would revolt. Put enough layers of obfuscation on top of that and boom. Artificially and perniciously paywalling access to basic medical care becomes a Viable business model.
dr decker - i am in need of your opinion on an offer from a PE firm - can you please spare me 2 minutes of your time? i couldn't find your email anywhere - please reach out if possible to me was unable to message you on twitter as well. your talks are exceptional. thank u!
