The real problem is the billing model we have, where every individual act a clinician performs is separately billable... and separately haggle-able.
One model that has shown promise is "bundled payments." For example, imagine that a certain insurance company switches to a bundled model for childbirth. They say, "we will pay a hospital $X to cover everything related to this patient's childbirth. Maybe it will be a very simple birth and the hospital will make a lot of money on it. Maybe it will be more complex/expensive, and the hospital will make less money. In some rare cases, the hospital will actually lose money."
Why is this a better model? Well, 2 reasons:
1. the hospital has an incentive to provide care efficiently, rather than trying to churn out as many procedures as possible so they can bill more
2. there's just fewer numbers for providers and payers to haggle over
One model that has shown promise is "bundled payments." For example, imagine that a certain insurance company switches to a bundled model for childbirth. They say, "we will pay a hospital $X to cover everything related to this patient's childbirth. Maybe it will be a very simple birth and the hospital will make a lot of money on it. Maybe it will be more complex/expensive, and the hospital will make less money. In some rare cases, the hospital will actually lose money."
Why is this a better model? Well, 2 reasons:
1. the hospital has an incentive to provide care efficiently, rather than trying to churn out as many procedures as possible so they can bill more
2. there's just fewer numbers for providers and payers to haggle over