Compliance Plan Health Care
Can you summarize this reading below in your own words?
Many employers and health plans are paying extra attention to patients with chronic conditions and costly, complicated illnesses, according to a center for studying Health System Change study release on October 8. Aiming to control costs, many employers are turning to disease-management programs in hopes of slowing double-digit health insurance premium increases.
Disease-management programs typically focus on patients with chronic conditions, for which practitioners’ adherence to evidence-based treatment guidelines and patient self-care and compliance are important to managing the conditions. Employers also are experimenting with intensive case-management programs that use highly individualized care coordination for high-risk patients with multiple or complex medical conditions.
Insurance companies and employers are focusing on certain chronic illness in an attempt to gather physicians that have proven themselves in being proactive and well educated in handling patients with that disease. In the office I work in my physicians pull charts on patients with these chronic illness’ (diabetes, COPD, CHF) and the insurance companies will check certain indicators (labs, foot exams, eye doc visits, education, etc) and if we pass on effectively handling our patients then we are listed with that company as being accredited in handling those diseases. The only way the physicians are able to practice like this is that they are being paid according to the diagnosis of these patients, not the actual visits. The sicker or higher risk the patient, the more the doctor will get.
Employers are seeking insurance companies that are doing this because it is more cost effective to effectively manage a disease than it is for the patient to wait until their symptoms are far gone.
Texas Straight Talk – Ron Paul Healthcare Plan Based on Economic Fantasy 8-3-09