You're so good at explaining complicated topics and have great energy. Thank you so much for these videos, I work in healthcare tech and this is eye opening.
Don't forget Humana is rapidly expanding CenterWell Primary Care. Here in Arizona the largest healthcare system, Banner Health recently expanded from MA DSNP only to MA HMO & PPO plans as well. Keep up the great work, Dr. Bricker. Thank you!
Love your teaching style. Very detailed and on point. Was able to follow the words spoken vs words written on board perfectly. Thank you. Very informative. Love when all of a sudden your video pops up on my RUclips.
Love your videos. I’m a healthcare lawyer working with small/medium size clinics and provider groups and find them very helpful. There was an article in the wsj titled “you arent as sick as government claims” with a proposal on direct deposit to medicare beneficiary hsa plans to avoid upcoming and insurer tactics. Might be a good video topic.
Dr Bricker is such a beast. Last 90 seconds of this video I’m thinking, “Okay, so hospitals are shifting the profit to themselves? What’s the problem?” @8:04 “So here’s why it’s a problem…” Well played, sir. Well played…
Couple questions - don't commercial plans have MLRs as well, so why do inter company eliminations only affect MA? And in your example, the $6120 you call profit - is that actually profit, or is it just what the payvider gets to keep (and might have to spend on physician care for the bene and thus actually keep less of the $6120 after costs)
Hi Dr. Bricker, Thank you for another great video! At the end you mention hospitals will go to carriers to get more money from commercially insured on self-funded plans. Are you talking about provider contracts and wouldn't fully insured plans also be affected?
Yes, but insurance carriers want fully insured groups to have steady trending higher claims so the insurers can raise premiums and keep the 15% MLR of a larger number.
Hospitals may have a leg up in being payviders due to being 340B covered entities. UPMC is and some others too. Locally Mass General Brigham has several 340B hospitals.
Dr. Bricker I so enjoy these videos, thank you! Vertical integration in healthcare is such a hot topic, I'd be curious to learn more about why entities like United/Optum seem to be getting a lot of the VI criticism, but entities like Kaiser Permanente do not receive this level of criticism. Is it because one is an open network, and the other is closed? Other reasons you might think? Thank you!
Are there additional administrative costs that the provider has and now are the responsibility of the payvidor which decreases the profit so that it’s less than the 50% that you calculate?
As a general rule, risk-based compensation arrangements, where providers are more profitable the better the job they do keeping people healthy, catching disease processes early, advising on behavioral health issues, etc. represent significantly better alignment of incentives among payers, providers and patients than fee-for-service compensation arrangements. I would be curious to hear if anyone has a different view on this topic. Thanks!
Do you believe a free market healthcare system would decrease costs, increase innovation, and improve service quality among hospitals and pharmaceutical companies especially if you got rid of things such as certificate of need to allow more local hospitals to compete with one another?
Sir, I'm a professional graphic designer with 2 years of experience and I really want to work with you as a thumbnail designer. Because I reviewed your youtube channel & I found that your current thumbnails are looking very simple not looking that much clicky, eye catchy & attractive which is really not suitable on your channel. So if I do work with you then it will save your time as well as your videos will perform much better and I will make very attractive, eye catchy and high quality profesional thumbnail for you that will grab the viewer's attention and increase the CTR of your videos for sure. Would you like to see my portfolio?
You're so good at explaining complicated topics and have great energy. Thank you so much for these videos, I work in healthcare tech and this is eye opening.
Thank you for watching and for your feedback.
Don't forget Humana is rapidly expanding CenterWell Primary Care. Here in Arizona the largest healthcare system, Banner Health recently expanded from MA DSNP only to MA HMO & PPO plans as well. Keep up the great work, Dr. Bricker. Thank you!
Thank you for those additions.
Love your teaching style. Very detailed and on point. Was able to follow the words spoken vs words written on board perfectly. Thank you. Very informative. Love when all of a sudden your video pops up on my RUclips.
Thank you for watching and for your feedback.
Excellent intro to Payvider trend - thank you Dr Bricker.
Thank you for watching and for your feedback.
Love your videos. I’m a healthcare lawyer working with small/medium size clinics and provider groups and find them very helpful. There was an article in the wsj titled “you arent as sick as government claims” with a proposal on direct deposit to medicare beneficiary hsa plans to avoid upcoming and insurer tactics. Might be a good video topic.
Thank you for your suggestion.
Dr Bricker is such a beast. Last 90 seconds of this video I’m thinking, “Okay, so hospitals are shifting the profit to themselves? What’s the problem?”
@8:04 “So here’s why it’s a problem…”
Well played, sir. Well played…
Thank you for watching and for your feedback.
Would love more insight on payviders, especially from a contracting perspective!
Thank you for your feedback.
Couple questions - don't commercial plans have MLRs as well, so why do inter company eliminations only affect MA? And in your example, the $6120 you call profit - is that actually profit, or is it just what the payvider gets to keep (and might have to spend on physician care for the bene and thus actually keep less of the $6120 after costs)
Hi Dr. Bricker, Thank you for another great video! At the end you mention hospitals will go to carriers to get more money from commercially insured on self-funded plans. Are you talking about provider contracts and wouldn't fully insured plans also be affected?
Yes, but insurance carriers want fully insured groups to have steady trending higher claims so the insurers can raise premiums and keep the 15% MLR of a larger number.
You can Health First (Brevard Co. FL) to that list. They started with this model back in the late 90's.
Thank you for the addition.
Hospitals may have a leg up in being payviders due to being 340B covered entities. UPMC is and some others too. Locally Mass General Brigham has several 340B hospitals.
Thank you for the info.
Dr. Bricker I so enjoy these videos, thank you! Vertical integration in healthcare is such a hot topic, I'd be curious to learn more about why entities like United/Optum seem to be getting a lot of the VI criticism, but entities like Kaiser Permanente do not receive this level of criticism. Is it because one is an open network, and the other is closed? Other reasons you might think? Thank you!
I appreciate your detailed breakdowns, although this is such a sham it feels like justifying a protection racket.
Thank you for your comment.
This is a really good summary
Thank you for watching.
Are there additional administrative costs that the provider has and now are the responsibility of the payvidor which decreases the profit so that it’s less than the 50% that you calculate?
As a general rule, risk-based compensation arrangements, where providers are more profitable the better the job they do keeping people healthy, catching disease processes early, advising on behavioral health issues, etc. represent significantly better alignment of incentives among payers, providers and patients than fee-for-service compensation arrangements. I would be curious to hear if anyone has a different view on this topic. Thanks!
Thank you for sharing your thoughts.
Do you believe a free market healthcare system would decrease costs, increase innovation, and improve service quality among hospitals and pharmaceutical companies especially if you got rid of things such as certificate of need to allow more local hospitals to compete with one another?
Yes. Thank you for your comment.
this seems like it should be illegal, it seems anti competitive towards small health care providers
Yes. It is legal. Thank you for watching.
@@ahealthcarezmaybe legal bc they paid off corrupt govt to get their way
The audio in a video is more important than the image quality...
Thank you for your feedback.
Kaiser is terrible. Don’t use them if you can help it.
Thank you for sharing your experience.
Sir, I'm a professional graphic designer with 2 years of experience and I really want to work with you as a thumbnail designer. Because I reviewed your youtube channel & I found that your current thumbnails are looking very simple not looking that much clicky, eye catchy & attractive which is really not suitable on your channel. So if I do work with you then it will save your time as well as your videos will perform much better and I will make very attractive, eye catchy and high quality profesional thumbnail for you that will grab the viewer's attention and increase the CTR of your videos for sure.
Would you like to see my portfolio?