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How the payer market could change in the next 5 years

Mark Reinford predicts consolidation amongst big payers and consolidation in fee schedules in the payer market in the next five years. 

As the coder and credentialer for Keystone Urology Specialists in Lancaster, Pa., Mr. Reinford spoke with Becker's ASC Review on his bold predictions for payers.

Editor's note: This interview was edited lightly for clarity.

Question: What are your predictions for the payer market in the next five years?

Mark Reinford: I see more consolidation with the big payers. I predict Aetna, Cigna, UnitedHealth and the Blue Cross Blue Shields garnering more market share as they diversify their offerings both in the standard commercial market and their "boutique" — for lack of a better word — markets. 

They will also try to corner as much through the Affordable Care Act markets as possible. I do not see much relief cost-wise for the average consumer, as the deductible/out-of-pocket amounts will rise. While I would love to see "Medicare for All," I think we may start to see some consolidation in fee schedules in some areas moving toward single-fee schedules versus multiple-fee schedules.

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