124 ◾ Physician Alignment
is confusing and clouds many of the inadequacies of our system. Fees are set to
maximize reimbursement and confuse noncontracted payers. Private-pay patients
are forced to pay retail.
e current payment system is also designed to cost shift. Some providers lose
money treating Medicare patients, and most lose money treating Medicaid patients.
Almost all providers lose money with self-pay individuals since few patients can
afford to pay for their own healthcare costs. Because of these challenges, hospitals
and other providers must charge commercial payers a premium to cover the costs
of these less-profitable payers. is is an indirect tax on the employers that are
paying commercial premiums. is situation is making it ...