At DocSpot, our mission is to connect people with the right health care by helping them navigate publicly available information. We believe the first step of that mission is to help connect people with an appropriate medical provider, and we look forward to helping people navigate other aspects of their care as the opportunities arise. We are just at the start of that mission, so we hope you will come back often to see how things are developing.
An underlying philosophy of our work is that right care means different things to different people. We also recognize that doctors are multidimensional people. So, instead of trying to determine which doctors are "better" than others, we offer a variety of filter options that individuals can apply to more quickly discover providers that fit their needs.Got questions?
In another sign of how health care in America is changing, members of a collaborative charged with improving health outcomes have recommended that providers offer some sort of warranty on their services. The cited example suggests that patients should not be financially liable for their care if they experience certain avoidable complications. The article draws a comparison with certain professions where if workers in those industries fail to maintain basic standards, the customer expects not to pay.
This recommendation follows in the same vein as what Geisinger Health System has already pioneered. Likewise, Medicare has started to reduce payments if providers have poor outcomes. As patients are expected to pay more and more out-of-pocket, it would not be hard to imagine their becoming savvier in their shopping for certain operations and preferring guarantees such as this one.
The National Academy of Sciences issued a report that outlined recommendations for the federal government to make medicines more affordable. The New York Times and NPR both summarized the recommendations.
Among the recommendations are the ideas that the federal government should negotiate prices with drug manufacturers and that the government should be able to deny coverage of certain drugs. The first part seems obvious, although prior legislation prohibits the federal government from doing so. The second part is also important in that it gives drug manufacturers a strong incentive to market their products heavily to physicians and patients without concern for efficacy or price-effectiveness. Generally, people would not be willing to pay more for a product than the perceived benefit; however, since insurance shields consumers from much of the cost, the manufacturers can be paid handsomely by the government as long as they can convince consumers that the benefit of their product exceeds the out-of-pocket costs. In such a situation, the payer (the government, in this case) may design policies to encourage the use of more cost-effective products.
The report also recommended steps to foster competition, including expediting the review of generics and attacking an industry practice known as "pay for delay," where a drug manufacturer pays a generics manufacturer to delay introducing a competing product.
Interestingly, the report also recommended removing the financial incentives given to doctors to prescribe more expensive medicines (for example, giving the doctor a percentage of the price of the drug). Apparently, when HHS considered such changes last year, parts of the medical community "launched an intense lobbying effort against it."
Happy Thanksgiving from the team at DocSpot!
Kaiser Family Foundation compiled and published year-over-year changes to the Affordable Care Act premiums through an interesting interactive presentation. Readers can get a heat map of percent changes across the nation, across the different metallic tiers of coverage.
A particularly interesting feature of the presentation is that it allows readers to get a sense of how much difference they might pay after accounting for the subsidies. Just because the premiums rise does not necessarily mean that patients will pay more after subsidies. The interactive tool presents options for different income levels for a hypothetical 40 year-old person.
Kaiser Health News published some research showing the decline in the number of insurers participating in the exchanges for the Affordable Care Act. In the first year that the exchanges were operational, states on average had five participating. That average dropped to 3.5 in 2018, with eight states having only one participating insurer (in 2014, there were two). In 2015 and 2016, the average was higher than where it started in 2014.
These few data points are not enough to draw a trend line, but the latest statistic is not encouraging. The interactive map gives a sense of how many more counties only have one option.