Scott Becker: It’s not so much a purposive intent — or at least, the government and big medical business would never admit it is. That stated, the cumulative impact of policies and laws being implemented is shifting more business from commercial payors to government payors. Further, government payors and their ACO policies are driving providers to organize around big institutions. It’s very hard for independent practices or physicians to have the capital, take the risk or have the resources to organize these systems. In a downstream position, physicians have much less control.
Long term, the ultimate shake-out as to the survival of independent practice is still unclear.
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