Physician Negotiations: Landscape and Predictions Ron Howrigon

In this episode of Sound Practice, Ron Howrigon, president and CEO of Fulcrum Strategies, brings his extensive experience in the healthcare industry to the forefront. Having worked as a senior executive with major managed care companies like Cigna, Kaiser Permanente, and Blue Cross Blue Shield, Howrigon shares his journey. From negotiating contracts to founding Fulcrum Strategies, his consulting firm helps doctors and hospitals navigate the complex world of managed care agreements so they can focus more on patient care.

With a keen eye on the flaws of a profit-driven healthcare system, join us as we delve into the complexities of the healthcare system and discuss innovative solutions for a better future.

Key Takeaways:

Navigating Capitalistic Healthcare: Uncover the inherent problems of a for-profit healthcare system where insurers often prioritize shareholder profits over patient care. Howrigon also discusses Medicare reimbursement cuts and provides a balanced view on private equity in healthcare, highlighting both potential benefits and risks.

Changing Patient

Experience:

Over the last 30-40 years, increasing bureaucracy and challenges in accessing necessary care have dramatically altered the patient experience, leading to poor health outcomes and a more critical patient perspective on the industry.

Solutions and Reforms: Howrigon suggests vital reforms to ensure medical directors for third-party payers adhere to medical practice standards when approving or denying claims, aiming to enhance patient care.

Impact of Physician Employment: Explore how the shift from self-employed physicians to those employed by non-physician-controlled organizations affects relationships at every level of healthcare. Howrigon predicts significant access issues and reimbursement changes because of the worsening physician shortage.