By Emily Berry
American Medical News, July 9, 2012

Payers are well aware that physicians and hospitals need the kind of business expertise that insurers have held almost exclusively until now: how to track claims, coordinate care, administer case management and deploy a new records system.

Health insurers are offering physicians and health systems access to that expertise — for a price. UnitedHealth Group’s enormously profitable Optum subsidiary is one example of that business angle. Indeed, Dr. Safavi said, some hospitals and doctors may be in a position of paying Optum for consulting and information technology expertise so they can be prepared for the demands that United and other insurers will make under new payment models. They will have to pay United before they can get paid by United.

http://www.ama-assn.org/amednews/2012/07/09/bisa0709.htm

Comment: 

By Don McCanne, MD

What did you expect? As long as private insurers are left in charge, as they are under the Affordable Care Act, they will always figure out a way to work the system to benefit themselves. We really do need to replace them with a single payer system.

How to split the health care dollar (America’s Health Insurance Plans meeting)

By Emily Berry
American Medical News, July 9, 2012
Payers are well aware that physicians and hospitals need the kind of business expertise that insurers have held almost exclusively until now: how to track claims, coordinate care, administer case management and deploy a new records system.
Health insurers are offering physicians and health systems access to that expertise — for a price. UnitedHealth Group’s enormously profitable Optum subsidiary is one example of that business angle. Indeed, Dr. Safavi said, some hospitals and doctors may be in a position of paying Optum for consulting and information technology expertise so they can be prepared for the demands that United and other insurers will make under new payment models. They will have to pay United before they can get paid by United.
http://www.ama-assn.org/amednews/2012/07/09/bisa0709.htm

What did you expect? As long as private insurers are left in charge, as they are under the Affordable Care Act, they will always figure out a way to work the system to benefit themselves. We really do need to replace them with a single payer system.