Medical fees in the era of managed care

Francisco Javier Sámano Guerra; Héctor Fernández González

2002, Number 2

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An Med Asoc Med Hosp ABC 2002; 47 (2)

Medical fees in the era of managed care

Sámano GFJ, Fernández GH

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Language: Spanish
References: 30
Page: 118-127
PDF size: 58.70 Kb.

ABSTRACT

The reason to analyze the different forms of reimbursement used by the third party payers in the United States and their estimation of the physicians’ fee has become a matter of interest for our profession in Mexico because of the coincidence of two significant facts. The first one is a recent change in the Mexican law, legalizing the development of a health care system known as Managed Care, controlled by the private insurance companies and their investors, similar to the prevailing model in the United States, their country of origin. The second one is the lack of a reliable fee schedule method capable of estimating in a just, objective, equitable and reproducible manner the value of medical services. Because these circumstances occur amidst the absence of solidarity and togetherness among the medical profession, the third party payers have unilaterally decided the amount paid to physicians for their work, with fares that do not compensate the quality of care provided to their insured population.

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