Regarding the Sept. 7 editorial “A better way to end balance billing” (Modern Healthcare, p. 24): It's an outrageous assumption that allowing one “provider” to decide how the allocation of reimbursement is to be distributed is a reasonable solution. There is no way this will ever be viewed as fair and reasonable by providers who are not in control of that distribution.
Cronyism and internal network connections will corrupt it, I guarantee it. The better choice is to force the hospitals to require that their contracted physicians (emergency room doctors, radiologists, pathologists, anesthesiologists, etc.) be on contracts that mirror theirs. They can force this issue, but they have not been diligent enough to do it.
The way to get everyone in line is to not give the power of distribution to an individual or single entity. You are effectively creating a “monarchy” where the king or queen will decide how the money gets distributed and hospital network physicians will get preferential treatment to the extent that it will be abusive. Take the corporate large practice specialties and make them be in-network as a requirement of their contract with the hospital.
