Friday, March 25, 2016

Family Medicine: Quality Suppressed by Insurance Companies- Costs of Care Driven Up

I got another threatening letter from an insurance company.  I have thirty percent more long visits than my peers.  Since I didn't align with what my peers do, they are threatening to audit me.  How do you insured folks feel about your insurance company pressuring your Family Physician to do less (or at least to code at a lower cost to them)?  With all the guidelines and other quality initiatives inflicted on Family Physicians in recent years, one should only expect that the level of service would go up and the charges would go up.  But no, they want them to remain the same.  Unfortunately, the majority of FP's undercode their visits for a wide variety of reasons.  Self esteem is a big one.  Training is another one.  Afraid of the insurance companies is another one.

I used to think that pressuring a whole group to do the same financial thing with their business was price fixing and would be outlawed by the Federal Trade Commission.  I guess that's not true.

Employers have no idea that the physicians caring for their employees are being pressured by the insurance company to do less, allowing their employees to be referred to more subspecialists because the physician held down the level of service at the primary care level and sent it up to the more expensive level.  The insurance company is forcing the costs up and driving the premiums up.


What do you think?

Eat Bacteria, Bacteria Food and Fats to Stay Healthy, Medical Geezer Reflections on Internet Radio

Your host, Dr Jonas, will reflect on a fermentation session he attended today.  Kefir, kombucha, scoby and scoby hotel were some of the interesting subjects.  The food world is changing and physicians need to keep up.  
Physician burnout is a growing factor in workforce development for healthcare.  The "Match" for med students adds little hope for an adequate primary care workforce for America.  Dr. Jonas reflects on the role that Direct Primary Care may play in shifting med student specialty preferences.

What is Liberty Health Share and Liberty Direct?  Dr. J explains his practice transformation into Neighborly Family Medicine and Family Health Connections, Inc.
Pain management, pressures on physicians to not (ever) prescribe opiates and the role of the state medical board come up in the discussion (OK, monolog).
Dr J reviews TdaP immunization in pregnancy study in JAMA and a letter to the editor. 
Tweet review is brief. 
The blog post of Medical Mojave is reviewed (welcome back MM).
Blog, Tweet and literature review is always a part of the show.  The OSMA Annual Meeting is coming up.  What's big?
Dr. Jonas manifests his Medical Geezer status to pontificate a bit, too.  (No surprise)