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Inbox: Higher Deductibles Cramp Physicians, Patients

Inbox: Higher Deductibles Cramp Physicians, Patients

Editor's note: We work hard to write about issues that will help physicians run their practices in a manner that is both prosperous and efficient, while still delivering quality patient care. And we are delighted when our readers let us know what they are thinking. This month we are excerpting an article by associate editor Erica Sprey on physician frustrations with the rising costs of doing business, and a blog by primary-care physician KrisEmily McCrory on why she thinks EHRs aren't really the problem. The articles has been edited for space and are followed by comments made by readers at PhysiciansPractice.com.

Physicians are becoming increasingly alarmed about the meteoric rise in costs to provide healthcare to their patients. Physician Practice's 2016 Great American Physician (GAP) Survey found that one-fifth of the 1,314 physician respondents say rising deductibles and cost sharing represent the largest barrier to good healthcare for their patients.

Pediatrician Terence McAllister and his spouse Leann DiDomenico McAllister, co-owner and practice administrator for their Plymouth, Mass.-based micropractice, Performance Pediatrics, say their practice and patients have been feeling the ill effects of a state decision to reel back reimbursement rates for the poorest patients. …

Complicating the financial picture, third-party payers are moving en masse to insurance products with higher deductibles, placing greater financial burdens on both medical practices and their patients. What can physicians do to navigate this trend and help their patients' better access care?

Deborah writes: This article leaves out a major point of contention for me — one which I am going to continue to scream from the roof tops. The insurance companies, the government, and now many of the medical societies continue to place administrative burdens on physicians and their staffs. At no point is anyone holding the insurance companies accountable for one simple solution: accurate benefits without a disclaimer. I get the reality of noncompliant patients. If you can't come to terms with that you should leave healthcare. Until mental, socio-economic issues are addressed you will not fix noncompliance.

We can fix the flow of accurate information. There is not one item in this country that you pay for after the fact except healthcare. You do not buy a car and receive a bill in the mail. Nor groceries or any other product. You want patients to understand their benefits? I have been an administrator and manager for 24 years and I still can't get a straight answer on most patients' benefits. We verify, educate, and collect up front. Insurance companies can still deny a surgery after the fact due to an unknown "policy exclusion." Patients would have to be attorneys to understand their coverage. The fix is simple, each insurance website should have the ability for providers to enter codes and received guaranteed benefits. No one should have to make medical decisions without proper cost determination.


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