We're indeed honored to have Dr Val Jones guest-blogging here at IB. In Part 1, she identified some of the wasteful expenditures to which health insurance companies are prone. Now, we'll learn about some possible alternatives and solutions:
Unfortunately, the cognitive therapy- compliance solution hasn’t been sufficiently incentivized. Physicians are poorly compensated for teaching patients how to stay well, and highly compensated for performing procedures. Primary care physicians in particular are struggling to cover their office overhead as their work is undervalued and underpaid in comparison to their peers.
What should we do? Third party payers should fight the urge to reward care that can be quantified with spreadsheets and check boxes (e.g. procedures) and compensate cognitive services at a rate that would improve behavior modification and treatment compliance. That $50/visit that insurance companies are saving by low-balling PCP visits may be costing them 177 billion/year.
Do I think that (given enough time) a primary care provider could help their patients achieve a 100% compliance rate? No way. But I bet they could improve it by 20-30%. And that would save lives, reduce complication rates, decrease costs, and improve the health of many with chronic diseases.
Improving medication compliance, combating chronic disease, and helping America become a “wellness culture” begins with a solid primary care base. The health of the insurance industry (and pharmaceutical industry) rests in the hands of the very physicians who are currently being run out of business with decreasing reimbursements and increasing overhead.
Let’s change that.
Thanks to Dr Val for stopping by, and sharing with us a vision from inside the health care side of the table. We'll let our readers know right away when her new blog goes live.
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