Over roughly the past year Prof. Blumberg and her Georgetown Center for Health Insurance Reform (CHIR) colleagues have been researching healthcare providers and payers increasing use of third-party entities they collectively termed “middlemen” with whom providers and payers contract to provide various supportive administrative or financial services. For example, payers frequently use of Third Party Administrators/TPAs and providers of Revenue Cycle Managers/RCMs. The use of middlemen is a problem because these entities are “rent seeking,” meaning they profit without creating new or additional value, thereby reducing economic efficiency and competition and driving prices up. In CHIR’s October report titled, The Complex Web of HC Fin Interests & Their Implication for Even Higher Spending,” Prof. Blumberg and her colleagues concluded relationships with middlemen have “resulted in a complex web of cost increasing incentives, money flows, and conflicts of interest. The complexity is so tremendous that it is virtually impossible to capture the entire picture of the existing financial relationships.” (Listeners may recall interviewed Leigh’s Prof. Katz-Olson in March 2022 regarding her related work, “Ethically Challenged, PE Storms US Health Care.”
CHIR writings discussed during this interview include:
https://chir.georgetown.edu/events/why-health-care-costs-are-rising-the-role-of-corporatization-and-bipartisan-solutions-to-increase-affordability/
https://chir.georgetown.edu/events/why-health-care-costs-are-rising-the-role-of-corporatization-and-bipartisan-solutions-to-increase-affordability/
CHIR’s publication page is at: https://chir.georgetown.edu/search/?filter=publications
