Comments on: Beware of Fake Transparency http://blog.seankhozin.com/2008/05/23/beware-of-fake-transparency/ The Healthcare Weblog Fri, 16 Apr 2010 03:05:20 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: Sean Khozin, MD, MPH http://blog.seankhozin.com/2008/05/23/beware-of-fake-transparency/comment-page-1/#comment-171 Sean Khozin, MD, MPH Fri, 23 May 2008 20:55:22 +0000 http://blog.seankhozin.com/?p=60#comment-171 gan, In the name of transparency Aetna is doing two things: 1. It is diverting patients to doctors who have negotiated lower fees with them (insurance companies are all about skimming doctors in a persistent attempt to keep the patient's dollars to themselves). Physicians take home less than 10% of healthcare dollars. That's why your doctor is seeing 30 patients a day and giving you only 5 minutes of face time. Many doctors are struggling just to break even. 2. They are forcing providers to comply with their set of arbitrary and meaningless quality measures. They may give doctors who have negotiated better deals lower "quality" ratings to divert patients to physicians who are reimbursed less but given higher made-up quality ratings. The consumer (patient) is paying the same premium no matter what the quality rating or the fees. All the "cost benefits" go to Aetna. gan,

In the name of transparency Aetna is doing two things:

1. It is diverting patients to doctors who have negotiated lower fees with them (insurance companies are all about skimming doctors in a persistent attempt to keep the patient’s dollars to themselves). Physicians take home less than 10% of healthcare dollars. That’s why your doctor is seeing 30 patients a day and giving you only 5 minutes of face time. Many doctors are struggling just to break even.

2. They are forcing providers to comply with their set of arbitrary and meaningless quality measures. They may give doctors who have negotiated better deals lower “quality” ratings to divert patients to physicians who are reimbursed less but given higher made-up quality ratings.

The consumer (patient) is paying the same premium no matter what the quality rating or the fees. All the “cost benefits” go to Aetna.

]]> By: gan http://blog.seankhozin.com/2008/05/23/beware-of-fake-transparency/comment-page-1/#comment-170 gan Fri, 23 May 2008 20:15:45 +0000 http://blog.seankhozin.com/?p=60#comment-170 I dont get it. What is Aetna doing? I dont get it. What is Aetna doing?

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