A team advocating better health care for Americans is warning that trouble looms because insurance operations now are buying doctors.
“What happens when a health plan purchases, runs or otherwise engages in the everyday operations of a hospital or clinic?” asks the Citizens’ Council for Health Freedom, CCHF.
The organization, which fights for patients’ privacy rights and the independence of physicians, is citing a plan in Minnesota that poses “a troubling conflict of interest between patients and doctors.”
CCHF said Blue Cross Blue Shield, beginning in January, will co-own 20 outpatient clinics within the North Memorial Health system.”
That amounts to 49 percent of the clinics in the system.
“These partnerships and mergers are reshaping medicine,” said Twila Brase, the president of CCHR.
“What happens to the charitable mission of medicine when payers and providers merge? With Blue Cross Blue Shield running the clinic, who is the doctor working for? Patients or the payer? How will Blue Cross Blue Shield influence what doctors can and cannot do for patients?
“To what extent will a health plan running a provider group improve the health plan’s bottom line by restricting access to care? And who owns all the data?”
Her organization famously has fought for privacy rights for patients in various states, focusing several times on the blood spots that are obtained from newborns. While hospitals routinely use the spots to test for inherited conditions, state officials had been retaining – and essentially acting as the owner – all of the DNA information.
CCHF has been successful in multiple lawsuits to prevent the government from maintaining that personal information.
The Minnesota plan, Brase said, will create a separate business entity to address “increasing financial pressures” and “focus on cost reduction by eliminating much of the administrative burden that has defined the relationship between payers and providers.”
At least that’s what corporations say.
“We’re concerned that such consolidation within the industry will lead to higher costs for patients and centralized controls over the provision of care. Simply put, the payer with all the premium dollars and the provider with all the medical skills are in a business partnership, but the patient, with neither the funds nor the skills, is vulnerable to whatever corporate limits the joint venture may decide to impose on patient care,” Brase explained.
The irony, she pointed out, is that Obamacare bans doctors from owning their own hospitals “due to a conflict of interest.”
It’s not the only conflict of interest developing.
In April, Blue Cross and Blue Shield of Texas announced a partnership with Sanitas to open 10 primary-care medical centers throughout Dallas and Houston. UnitedHealth’s Optum acquired DaVita’s large group of independent physicians, and CVS Health completed its acquisition of the insurer Aetna last November.