“Juicing the Vig on the SOS” is an Obamacare (un-Affordable Care Act) enabled scheme between hospitals and employed physicians that became popular in the early 2000’s to defraud patients and Medicare.
The scheme was designed to promote consolidation in healthcare in order to direct and control patient care. It depends upon physicians giving up autonomy in order to work for hospitals who direct them to do procedures in high reimbursement sites of service, order imaging, tests from hospital owned imaging centers, order u-tox from hospital owned labs, etc in exchange for more salary than the physician would otherwise receive if they were independent.
The hospitals can afford doing this because of a site of service differential and greedy or lazy physicians are more than happy to be complicit in the scheme. The scheme is inherently inflationary and also creates an unlevel market place for independent physicians.
I started raising awareness about this trend circa 2005 when patients would show me their EOB’s for yhe same service done at a hospitall, ASC, or HOPD. It is eye-popping. HOPD physicians, here and other places, resent having the conversation claiming that they’ve never been told about SOS or that they’re being paid to work for the hospital that uses large facility fees to subsidize their salary. Most deny that the scheme exists but it is actually Frderal policy, supported mostly by Left-leaning politicians who want “free healthcatw” for their constituents.
Some brave MD/DO’s have started to step forward and talk about their experiences of being directed and controlled into trading SOS for salary. Now, even some D’s in Congress are concerned (Wyden and Warren) about the scheme’s “unintended” consequences—skyrocketing costs and consolidation—but for the last 20 years the HOPD-employed MD’s have been laughing all the way to the bank.
In the 2010’s I completed a health policy fellowship and studied the issue. The policy and scheme have all but wrecked the American health care system.
Thanks, Obama.
