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How can you determine reimbursements without performing "job Costing?"

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I think you can do cost account very easily and include a weighted average for frequency of claims. In addition, you’d run several hedging models based on the anticipated “savings” by having primary care physicians. If the world does not believe that Primary Care helps, then they ought to be eliminated. The health systems use them as glorified sales people, not to help. I love PCPs and think they have the abilities to reduce overal spend.

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But yea, we have a free market. We have anything but.... Not only in most cases are prices fixed, regardless of quality or the physican, but this dramatically skews the supply & demand of physician specialties/subspecialties.

E.g. A fellowship trained & very much in-demand Developmental & Behavioral Pediatrician might expect to make ⅔-¾ what a non-fellowship trained Pediatrician makes. It's no wonder ~½ the fellowship slots go unfilled. It's actually amazing that even ½ do get filled! And a regular Pediatrician might make ½ what a general surgeon makes, who again makes less than a surgeon in a subspecialty. Subspecialtists shold always make more than their non-subspecialist counterparts. The question is how much? Only a market can truly determine this.

Of course the AANP very smartly read the tea leaves long ago and along with the government's & AMA's misguided limiting of residency slots (again skewing the supply/demand of physicians) we now have degree mills pumping out unqualified PCPs. The AANP has exactly the opposite incentive that the AMA did over 100 years ago to standardize and make rigorous the education of doctors.

What a colossal mess. In the end, the patient loses.

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We have no free market. Well said!

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