Single payor may help solve issues from the payor side, however, it does nothing to enhance the experience of the patient. Look to countries who have used single payor for the past 40 years, patients can take up to 5 years to get a PCP assigned, requiring all needs to be managed through ED or Urgent Care facilities, months (6+) to get procedures such as MRI's etc., scheduled, if you are lucky. Surgeries scheduled out over a year. Colonoscopies must be scheduled 5 years out. It may seem bad here but nothing like single payor counties.
Cosmos - 3 days ago
Required reading on this topic: https://www.bostonglobe.com/2026/03/20/business/sepsis-hospital-billing-coding/
TL;DR - Studies find increasing severity of Sepsis and COPD in claims data, but no significan change in treatments delivered, supporting the theory that AI-assisted upcoding is just used to increase reimbursements. And nobody's happy.
Bob Abrahamson - 4 days ago
You say payment integrity
I say revenue cycle management
You say upcode
I say undercode
FWA, RCM, Updcode, Undercode
Our system if filled with rot
Let's look to single payer
And turn our current insurance system off . . .. apologies to the Gershwin's
Single payor may help solve issues from the payor side, however, it does nothing to enhance the experience of the patient. Look to countries who have used single payor for the past 40 years, patients can take up to 5 years to get a PCP assigned, requiring all needs to be managed through ED or Urgent Care facilities, months (6+) to get procedures such as MRI's etc., scheduled, if you are lucky. Surgeries scheduled out over a year. Colonoscopies must be scheduled 5 years out. It may seem bad here but nothing like single payor counties.
Required reading on this topic: https://www.bostonglobe.com/2026/03/20/business/sepsis-hospital-billing-coding/
TL;DR - Studies find increasing severity of Sepsis and COPD in claims data, but no significan change in treatments delivered, supporting the theory that AI-assisted upcoding is just used to increase reimbursements. And nobody's happy.
You say payment integrity
I say revenue cycle management
You say upcode
I say undercode
FWA, RCM, Updcode, Undercode
Our system if filled with rot
Let's look to single payer
And turn our current insurance system off . . .. apologies to the Gershwin's