When was the last time you had an appointment with a doctor in an independently-owned private practice? Did you know that fewer than half of practicing physicians work in their own practice?
What’s happening is that many doctors are choosing to work or sell their private practices to hospitals or big corporations because they cannot financially survive due to higher costs and the low fees insurance companies are willing to pay.
The expansion of the big healthcare companies, like Hartford or Yale Health, and rapidly growing mid-sized medical groups such as Midstate and ProHealth, as well as some newer, smaller companies, are changing the model of how healthcare is delivered in this country.
I’m sure we don’t have to tell you this. Most of you have experienced it. We hear our patients complaining about the lack of quality face-to-face time they have with their providers. Typically, you get to address one concern, and it is often met with a quick nod and a prescription for a drug.
Independent research quite broadly shows that as more doctors concentrate into these big systems, prices go up for patients. Why? Unlike independent practices, these larger healthcare companies have the power to demand higher rates from insurance companies, who, in turn, pass it on to their patients through increased premiums.
So, you are paying more and getting less.
The other side of the story:
The crunch on private practice.
Private Practices Are Suffering, Too
Meanwhile, the smaller private practice groups without any market power have to fight for rate increases from insurance companies who have little incentive to comply. To balance the market, some advocacy and physician associations have banded together to lobby for rate increases. This has been effective for some allopathic medical groups. But the population of what insurance companies have labeled “complementary providers,” including therapists, naturopaths, chiropractors, acupuncturists, and massage therapists, do not have market power and, therefore, have been left behind.
Think about this: The naturopathic physicians in our practice have not had an increase in insurance reimbursement rates in over 20 years! It seems unimaginable to those who are aware of the importance of preventative medicine, but trust me, it is the sad and honest truth.
If the expenses it takes to run an office were locked in at rates from 20 years ago, we would be in good shape. But between 2000 and today, the prices have had a cumulative increase of 76.61%. For this very reason, many “complementary medical practices” are opting out of insurance participation simply because it is not sustainable.
Pay More, Get Less
The landscape of healthcare in our country is undergoing a significant transformation, and
unfortunately, it’s not necessarily for the better. The shift toward consolidation within larger healthcare entities, coupled with the financial struggles faced by independent practitioners, has led to a disturbing trend: pay more and get less.
Many of us have experienced the diminishing quality of face-to-face time with our healthcare providers, a consequence of the financial strain they face. The increasing number of doctors joining big healthcare systems results in higher prices for patients. These large entities can demand higher rates from insurance companies, causing a ripple effect that ultimately burdens patients with increased premiums.
On the flip side, smaller private practices, lacking market power, struggle to negotiate for fair reimbursement rates from insurance companies. This struggle is especially evident for “complementary providers” such as therapists, naturopaths, chiropractors, acupuncturists, and massage therapists, who find themselves left behind in the ongoing healthcare transformation.
Advocate for Each Other
This stagnation is unsustainable, considering the cumulative increase in prices over the same period. The reality is that many complementary medical practices are forced to opt out of insurance participation, leading to a situation where preventative and holistic healthcare becomes financially unviable for both providers and patients.
It’s time to take action. As patients, we must advocate for a healthcare system that prioritizes quality care over profit margins. Support initiatives that seek fair reimbursement for all healthcare providers, irrespective of their specialty. Encourage legislation that addresses the growing disparities in reimbursement rates and market power among healthcare professionals.
Moreover, engage with healthcare policy discussions and demand transparency and accountability from both insurance companies and healthcare providers. By raising awareness and collectively pushing for positive change, we can contribute to a healthcare system that values accessibility, affordability, and the overall well-being of patients and practitioners alike. The never-ending trend of paying more for less in healthcare can only be reversed through a concerted effort to reshape the system for the benefit of everyone involved.
Dr. Michael Kane is a Naturopathic Physician at the Connecticut Center for Natural Health in Middletown. A graduate of Bastyr University in Washington State, Michael continually learns from his patients and takes the art of listening very seriously.
Connecticut Center For Natural Health is located at 210 S. Main St. Visit: yournaturalhealth.com or call 860.347.8600.