>> Economy of scale??
No, there is no economy of scale. The reason is that hospitals want feeders.
No one is talking about it right now. But in physicians offices today, real efficiency is at an all time low due to electronic medical records. Costs are rising dramatically, while quality is dropping like a rock.
Doctors are upcoding legally as a result of EHR, which tells them "Do this, this and this and your 99212 will bill as a 99214". And that is a cost that NO ONE is looking at. When the bill comes due it will have increased Part B and private insurance charges by 25-40%. Doc fix or no. Docs everywhere are adding supervised NPs who provide a lesser level of service but cost the same to the system.
So, due to EHR, costs are going up, actual interaction with the doctor has dropped like a rock, and docs spend more time complying with regulations and less time actually dealing with the patient. That's reality, and it is a highly destructive force in health care.
This is what happens when government regulates. Practically always. Obama thought, "We get these EHR systems in and efficiency will take off." And, predictably, it had precisely the opposite effect. A doc who was seeing 30 pts/day is now seeing 20, but billing more than before for them.
So, there is no economy of scale. There is a historic disruption, and that's about it. |
