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Cutting out the healthcare middlemen


The Grand Bazaar in Istanbul.

Herewith five areas of healthcare ready to cut out all or some of the middlemen:

“In fact, the perfect storm is brewing in healthcare for disintermediation right now.” reports Becker’s Hospital Review in an interview with Paul Keckley, Ph.D., managing editor of  The Keckley Report.

“{T]hree forces — large health systems, pharmaceutical retailers and major payers — are perfectly positioned to knock out a few layers of the healthcare food chain.”

1. Drug companies. There may be a quicker and cheaper way for patients to obtain pharmaceutical drugs, such as through direct sales to consumers. However, this is not a one-size-fits-all projection, Mr. Keckley told Becker’s.

2. Rural hospitals.  Big regional health systems will put rural providers into networks and move capital from inpatient acute care to skilled nursing, rehab and primary care. Telehealth will help connect specialists in urban and suburban areas with rural primary- care providers.

3. Academic medical centers: They will face many more competitors with lower costs as healthcare price-and-quality transparency increases. Patients are finding that they can get care  at the nonacademic hospitals that’s as good  as that at teaching hospitals. But who will protect the research mission?

4. Private insurers. They’ll have to compete with more and more health systems offering their own insurance plans to their patients and their families.

5. Physicians. Consumers want more access, engagement and transparency. They’re also less attached to  specific physicians and more open to non-physician clinicians, retail clinics and other venues that make care more convenient and often cheaper than going to U.S. physicians, who remain by far the world’s highest paid.

Drug firms use education programs to pay physicians


The Boston Globe looks at the large piles of money that drug companies send to physicians via the continuing-education programs that doctors must attend to keep their licenses.

The Globe reports that “Federal law allows pharmaceutical and medical device companies to funnel millions of dollars a year, without disclosure, to doctors who teach continuing education programs. The conduits for the money are independent companies that sponsor medical lectures for doctors. Since 2011, drug industry payments to these outside companies have risen 25 percent, to $311 million in 2014. …”

“The biggest lobbying organization for doctors is fighting in Congress to keep those payments out of public view, backing a bill to derail an Obama administration push for more transparency. The lobbying group, the American Medical Association, says disclosure would unfairly stigmatize doctors who are leaders in their fields and deliver lectures on breakthroughs in medicine.”


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