Would you think that hospital insurance companies would incentivize rather than disincentivize performing profitable procedures since they are taking a cut and passing on the expense to the employers. Especially, since there is not a lot of choice for insurers and perhaps the market doesn't function well to keep prices low for employers.
Dr. Bricker, the insurance company/payer is not keeping that 15% when the employer health plan is self-funded, right? However, this cross subsidization might benefit broker/consultants if they charge a shared savings fee during the claims adjudication process and their review results in savings. Is that correct or am I off base?
You are correct. The 15% applies to fully insured groups… hence why carriers and brokers prefer to keep groups fully insured. Thank you for watching and for your comment.
Dr. Bricker, how much do insurance companies keep for employer health plans? Just a relatively small administrative fee? @@ahealthcarez Thank you for making the video.
Great video! Can you please investigate and do a video on NPs, especially in outpatient settings, getting severely underpaid. Let’s say an NP is seeing 3 pt in an hr with a 99214 (charging $160/visit but having reimbursement rate of $70-110/visit, depending on the insurance). And NPs salary is $50-60/hr. Obviously the employer has benefits 401K's and other things to pay but that’s a profit margin of 420-550%. How is this even going on? And how is this even allowed? NPs are severely unaware and uneducated about reimbursement rates, and it seems like they're being taken advantage of because of this. Obviously, there is a huge educational difference between MDs vs NP and insurance companies in general reimbursed NPs 15% lower. But what in the world is going on with the NP salary? They're being used like a cash cow. Can you please do a deep dive in this? It would make sense if NPs were working less in outpt setting compared to MDs but in most places They have the same patient and volume load; honestly sometimes more than MDs. This is pure robbery and exploitation.
Great comments. It’s supply and demand. If the supply of NPs dries up, they will demand higher wages. Until then, their employers will exploit them as much as possible.
Sad but true. Online NP's who are lacking skills are flooding the market and working for peanuts, and giving little value in return. It won't get better anytime soon.
Okay well that was SUPER ENLIGHTENING!
Thank you for watching and for your support.
Great video! Subscribed!
Why does it cost insurance 350k for procedure that costs the hospital only 50k? Speaking to the scoliosis example
Reimbursement negotiated by hospital system.
Cross subsidization. It's literally the title of the video.
Would you think that hospital insurance companies would incentivize rather than disincentivize performing profitable procedures since they are taking a cut and passing on the expense to the employers. Especially, since there is not a lot of choice for insurers and perhaps the market doesn't function well to keep prices low for employers.
Dr. Bricker, the insurance company/payer is not keeping that 15% when the employer health plan is self-funded, right?
However, this cross subsidization might benefit broker/consultants if they charge a shared savings fee during the claims adjudication process and their review results in savings. Is that correct or am I off base?
You are correct. The 15% applies to fully insured groups… hence why carriers and brokers prefer to keep groups fully insured. Thank you for watching and for your comment.
Dr. Bricker, how much do insurance companies keep for employer health plans? Just a relatively small administrative fee? @@ahealthcarez Thank you for making the video.
Great video! Can you please investigate and do a video on NPs, especially in outpatient settings, getting severely underpaid. Let’s say an NP is seeing 3 pt in an hr with a 99214 (charging $160/visit but having reimbursement rate of $70-110/visit, depending on the insurance). And NPs salary is $50-60/hr. Obviously the employer has benefits 401K's and other things to pay but that’s a profit margin of 420-550%. How is this even going on? And how is this even allowed? NPs are severely unaware and uneducated about reimbursement rates, and it seems like they're being taken advantage of because of this. Obviously, there is a huge educational difference between MDs vs NP and insurance companies in general reimbursed NPs 15% lower. But what in the world is going on with the NP salary? They're being used like a cash cow. Can you please do a deep dive in this?
It would make sense if NPs were working less in outpt setting compared to MDs but in most places They have the same patient and volume load; honestly sometimes more than MDs. This is pure robbery and exploitation.
Great comments. It’s supply and demand. If the supply of NPs dries up, they will demand higher wages. Until then, their employers will exploit them as much as possible.
If hospitals had to pay NP’s as much as physicians, why would they hire them at all?
Spot on.
Sad but true. Online NP's who are lacking skills are flooding the market and working for peanuts, and giving little value in return. It won't get better anytime soon.
Can you comment on Kaiser Permanenete and their success
Sure. Here is a video on Kaiser: ua-cam.com/video/M-YgihI3XH0/v-deo.htmlfeature=shared
Please ask someone to make your writing in simple word document... your ways is way back to 50s and 60s way of teaching 😅
Thank you for your feedback.