3 ms·

The federal government has encouraged all this; if Medicare/Medicaid didn't cut payments, the private insurers likely would not have followed their lead. One o

The federal government has encouraged all this; if Medicare/Medicaid didn't cut payments, the private insurers likely would not have followed their lead. One of the big ways that cost containment has been done is forcing more efficiency. That should be a good thing, right? Except that small rural hospitals will never, ever be as efficient as large urban ones. And the "disproportionate share" (overly large amounts of Medicare/Medicaid patients) payments aren't enough to keep those places open. So while it's definitely saved money, that's not much help when you live an hour or more away from any healthcare facility.

jmye 1y ago
Medicare should be cutting reimbursements. It’s the only way to deal with runaway bullshit in a fee-for-service healthcare economy. The real answer is, and always will be, shifting the model entirely away from that to capitated models and better care model incentives (instead of incentives based around just ordering more shit for patients). It’s also an easy way to account for better geographic distribution. That said, you’re also not solving rural healthcare without dramatically increasing the number of providers, so the revenue models are only going to get you so far regardless.