PNHP Single Payer Healthcare Financing Series, Kip Sullivan JD
Kip Sullivan is known for his commentary on commercial healthcare and healthcare insurance. He is one of the few who can honestly depict what the issues are today and where we are going with healthcare in the US.
In this segment Kip discusses the overuse of healthcare claim of being caused by Fee for Service healthcare. This was supposedly reduced by HMOs and a method of payment called capitation (payment per patient per year). The use of capitation as the method of payment, will limit choice of provider and also micromanage doctors with utilization of review. This combination is the basis for Managed Care.
There is no supporting evidence which can be offered up that Fee for Service has led to the overuse of healthcare and resulting costs to the US. Both Kip and I have presented information it is the pricing of healthcare which is the cause. When compared with other countries, US pricing and the total cost of US healthcare.
Value Base Payment is the offshoot of HMO and is commonly known as the ACO.
This is approximately one hour long and packed with detail and statistics. Kip tracks the history of going from HMOs in the seventies, to ACOS with the advent of the PPACA more commonly known as Obamacare, and finally to DCEs in 2019 by the Trump administration.
Some Take Aways
DCEs are meant to begin the privatization of Medicare to Medicare Advantage. It was set to start in 2021 and has been pushed back to 2022 (from what I have read) due to the pandemic.
A key part of this presentation is Kip’s commentary. Managed Healthcare, better known as HMOs, ACOs, Advantage plans are no better than Fee for Service (FFS) Traditional Medicare in preventing Overuse and are worse for the under usage of healthcare.
Here again is a YouTube presentation.