you’re absolutely right. also, the seemingly universal mentality that docs regularly peruse their contracts and renegotiate them is a farce.

the reality is either

1- you join a group and are out of the contract negotiations altogether; or

2- you start your own small practice, sign on to EVERY insurance plan you can from the beginning to build up quickly, sign on every dotted line without reading the fine print, and never look at your contract again. then when insurers send you these periodic “notices” of rate reductions etc. they go right in the trash or in your file cabinet.

In any major market (NY, boston, philly etc.) insurers rule. You just can’t survive if you refuse to take the major insurers, and they know that.

That is because too many primary care doctors have a martyr complex and feel guilty if they stick up for themselves. The let the insurance companies use the patients to put them on a guilt trip if they say no to a contract.

but blue cross, oxford, hip, ghi, and united are all just a hair above medicaid (for primary care anyway)