The Houston Chronicle reports that an increasing number of doctors are opting out of accepting managed care contracts and going "off the grid" so to speak. The typical such doctor has been in practice for over 20 years, is in a 1- or 2-doctor office, or is not board certified in their specialty, making them less desirable to managed care networks. Currently, over 11% of all providers does not belong to any managed care networks.
A main reason these doctors are not interested in managed care is because of the administrative burden membership presents. The average doctor who is contracted with more than one health plan is contracted with 12. 12 health plans!! That's 12 different credentialing applications that need to be submitted, 12 different contracts to maintain, and 12 different sets of claim idiosyncracies to master. No wonder your average doctor dreams of the nirvana of not having to deal with all that hassle. But only the doctors who have been in practice long enough to develop a large patient base and an outstanding reputation can survive on patient payments alone.
Hmm... how could we reduce the administrative burden placed upon providers? I know! How about a single-payer system that is completely uniform? Maybe the government could contract with providers in a single point of entry into the system. Then the government could also fund 5 or 6 health plans with uniform benefit designs which compete for members based on service.
People who are opposed to single-payer say that competition is vital to improving the system as a whole. But this study comes as compelling evidence that the competition itself creates so much inefficiency that the system is losing some of its best providers. There will always be some doctors who will take payments only from the patients themselves (plastic surgeons come to mind), but 11%? Add this to the costs of a disjointed healthcare system loaded with inefficiencies.