Algorithms and health care

In the suburbs we call home, health care should be personal, local, and accessible. Yet across Lake and Cook counties, primary-care physicians are facing pressures that jeopardize this very model. As an independent family physician in Gurnee, I’ve watched insurers increasingly deploy algorithmic down coding — reducing claims for common evaluation and management services like 99214 to lesser-paying levels without review. This tactic not only undercuts physicians but ultimately drives patients toward fragmented, high-cost specialty care.

This hits close to home for suburban communities. Independent clinics like mine are tailored to local populations and offer continuity of care that large health systems often can’t match. Yet when reimbursement models fail to recognize this value, our survival becomes uncertain.

We urge insurers and policymakers to realign incentives. Value-based care must start with valuing the providers on the front lines. Sustaining local health care depends on fair pay for those who prevent disease, not just treat it.

Luis I Salazar

Gurnee