Barriers to updating medicare


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Since no insurer can afford to leave Partners out of its network, it can command much higher prices than other hospitals in the state.

For their part, physicians just want to keep their income up, while the wars between insurers and hospital conglomerates rage around them.

The best way to do that is to refuse to insure high-risk people at all, if possible; to shift costs to patients at the point of service by increasing deductibles and co-payments; and to limit the benefit package.

In contrast, hospitals and other facilities have every interest in expanding, so that they’re in a better position to bargain with insurers for higher prices.

They are mainly paid fee-for-service, and those fees are greatly skewed to reward tests and procedures.