Sylvia Romm, MD, MPH’s Post

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Founder and Chairperson, Physician and Healthcare Executive | Telehealth, SDoH, Virtual Care

The Insurance Influence: How Insurance Companies Impact US Healthcare Let's bring into focus a pivotal player in our healthcare landscape - insurance companies. Their role in dictating healthcare costs and outcomes is considerable and worth unpacking. Insurance companies negotiate prices, decide coverage limits, and determine out-of-pocket costs. While these responsibilities are essential to maintain the solvency of the healthcare system, they can also lead to inflated healthcare costs and inequitable access to care (Source 1). For instance, research has shown that different private insurers often negotiate wildly different prices with hospitals in a dance between the two to get the highest margin for themselves. The costs of higher margins are then passed onto patients (Source 2). Could more stringent price regulation be a solution? Moreover, insurance coverage is known to impact health outcomes. Those uninsured or underinsured often face barriers to necessary care, leading to poorer health outcomes (Source 3). How can we ensure that insurance expands access, not limit it? Lastly, let's talk about the role of 'prior authorization,' a tool insurance companies use to control costs. While effective in theory, it can delay care and increase administrative burden for physicians (Source 1). Can we streamline this process to eliminate barriers? These are just a few examples. Now, let's turn the mic to you. What do you think? What is the role of insurance companies in contributing to a more efficient, patient-centered healthcare system? Join the conversation. Let's put our collective minds together to inspire change. Together, we can make a difference. #USHealthcare #HealthInsurance #HealthcareReform Sources: 1. "Health Insurance Coverage and Health — What the Recent Evidence Tells Us," New England Journal of Medicine 2. "The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured," The Quarterly Journal of Economics 3. "Uninsurance and its Consequences," National Academies Press

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The role of insurance companies? Stop physician fraud, waste and abuse, of course.

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