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In Network, Out of Network, Who Cares?

Daniel Paull MD explains that there are a whole host of medical providers in the country, but that you're only allowed to see a select few of them, if you are trying to use your insurance.

In network, out of network, was in network and now is out of network.

The facility and surgeon are in network but the pathologist is out of network.

If the above sounds confusing, that’s because it is.

There are a whole host of medical providers in the country, but you are only allowed to see a select few of them if you are trying to use your insurance. Maybe you find some docs who you like, only to find out at the next visit that they no longer take your insurance, meaning that they are now “out of network”.

So maybe you go and find another doc who you like, only to undergo the same process a year later, when either the insurance changes again, or the doc you liked is no longer there.

It’s hard for patients to keep a doctor these days as insurance shifts are frequent, and turnover is so high. This leads to discontinuity in care, which in many cases leads to worse care.

 

It's hard for patients to keep a doctor these days as insurance shifts are frequent, and turnover is so high. This leads to discontinuity in care, which in many cases leads to worse care. Click To Tweet

 

We should get used to this process accelerating, meaning that physician turnover will increase to keep pace with physician burnout.

All of the above mentioned issues are health insurance related.

Remove the health insurance and provide transparent affordable cash pricing, and you have an un-burned-out doctor who has a stable practice and can provide higher quality care.

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