Hospitals need a new and simpler way of getting paid. Medicare and Medicaid reimbursement are now completely inadequate. In the past, reimbursement levels from Medicare and Medicaid have been driven by budgetary considerations rather than a cost analysis of providing care.
Commercial payers (i.e. Blue Cross Blue Shield, Humana, etc), have followed suit and used Medicare reimbursements for cover and use these low level payments as a way to justify their own woefully inadequate reimbursements. There has been no increase in insurance reimbursement levels for physicians or hospitals for years. Very few, if any, hospitals, medical groups, or ancillary services have made money in the last decade while insurance companies continue to make record profits for their shareholders and pay their CEOs multi-million dollar salaries.
All these factors are compounded by the astounding cost of meeting regulations and policies by both the public and private payors, just in order to try and to get paid. It is estimated that over 25% of the cost in our current healthcare system is related to the processing of claims.
The goal of any healthcare system should be to provide excellent access and quality care at a sustainable price.
We lost sight of that goal in this country decades ago. We still strive for excellent quality and improved access, but the goal of sustainability in pricing/reimbursement continues to elude us.
Medical Access Corporation of America stands ready to move us closer to achieving that goal via our model which reimburses hospitals a fair price for their services without the headache of billing, coding, and claims processing that traditional insurance companies utilize as a way to delay or decline reimbursement altogether.
Benefits for the Hospital