I and my group started making these first steps nearly a decade ago by first stopping signing insurance contracts. The reasoning for this is simple- these contracts don't result in patient savings and serve the insurance industry by validating their control of the system. Insurance companies do not deliver health care services- doctors and hospitals do. Thier contract should be between the patient and them, not us. In exchange for this decision
we have elected to publicly post prices for our most common services. This is how we doctors can begin to offer local market solutions to delivering health care.
Proper economic thinking is how to best optimize the delivery of our services. This is where I am coming from when I critique the centralists trends. Criticism alone is meaningless.