An alert for all medical plan participants. (A current post is directed at employers but this one is strictly for employees.) There is a new trend that is being inflicted on medical plan members. It’s called “low value care”. It is an attempt by insurance companies to encourage doctors and hospitals not to perform certain tests or use specific medications because their use is not always productive. Over the years medical providers (doctors and hospitals) have tended to grow defensive medical strategies to protect themselves against potential malpractice suits. This “defensive medicine” as it’s called has added billions of dollars of cost to the nations healthcare bill. The devil is, however, in the details. By questioning the medical care providers the insurer may be delaying what could be a life-saving test because the insurers’ stats suggest it isn’t ALWAYS needed…in some cases it may be absolutely needed and immediately. The question is: can a monetary justification be made for the savings generated by denying the individua test versus the cost of quality care, welfare of the patient and cost of malpractice if adverse consequences occur? The jury is still out on that evaluation. We suggest you work very closely with all your doctor when medical procedures are recommended.
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