By MATTHEW HOLT
Lately, there have been three stories that highlight the absurdity of our current health care system, all of which are exacerbated by the fee-for-service payment model. First, health insurers like United and Humana are struggling to predict and manage costs due to unexpected medical expenses. This is because providers are paid per transaction, leading to uncertainty and inefficiency in the system.
Secondly, UCHealth, a non-profit health system in Colorado, has been accused of engaging in aggressive and unethical billing practices, targeting vulnerable patients for trivial amounts of money. This predatory behavior is enabled by the fee-for-service model, which incentivizes providers to bill for individual procedures rather than focusing on patient outcomes.
Lastly, UnitedHealth’s acquisition of Change Healthcare, a major player in revenue cycle management, has backfired as the company recently experienced a major cyberattack. This disruption has exposed the complexities of the fee-for-service system, which relies on intermediaries like Change Healthcare to process claims and payments.
Overall, these stories highlight the flaws of the fee-for-service model in health care, which perpetuates inefficiency, greed, and unpredictability. Moving towards value-based care models, such as capitation or subscription-based payment systems, could help address these issues and improve the overall quality and affordability of health care in the US.
