Has the Health Care Industry Become more Business Oriented?

According to a report published by the researchers at The Dartmouth Institute for Health Policy & Clinical Practice earlier this year, evidence-based research has declined in the U.S. health-care system and corporate greed has degraded the entire system.

<a href="https://withdrawal-ease.com/">Health care</a> is a prominent global industry, a key responsibility of the government as well as businesses, but more than that, it is an essential human right. However, certain financial forces such as insurance companies, hospital networks, and regulatory groups are beginning to corrupt care and undermine the bond between doctors and patients.

<b>Pay-For-Performance Medical Contracts</b>

Pay-for-performance schemes are widely used by private payers and Medicare in the U.S. to improve the quality of health care and reduce costs. However, there’s little evidence whether or not these criteria actually improve quality or do any good to patients.

As per such policies, physicians are directed to meet stringent metrics for testing and treatment. But, these metrics don’t take into account the individual characteristics and preferences of the patient or differing expert opinions on optimal practice. Instead, they’re generic and population-based, which is why they are ineffective when it comes to improving patient outcomes.Say for example even for most simple of pain that can be cured without much of medication, doctors will suggest list of opiates, which on long term basis can cause serious health issues.

Perhaps, this is the reason why the report by the Commonwealth Fund shows the U.S. health-care system is the most expensive in the world. However, when it comes to health outcomes, the industry performs worse than 11 other industrialized nations in terms of health access, efficiency, and equity.

Physicians who achieve their targets are not only rewarded with a bonus from the insurer, but are also given high ratings on insurer websites. Physicians who deviate from such metrics, on the other hand, are financially penalized through lower payments and can suffer from poor ratings on healthcare review sites.

Situations where patient visits doctor with a minor health issue and comes out with huge medical bills have become common these days and there is still no proper solution to curb this situation. Lack of awareness among patient adds to these and works in the advantage of such physicians who involve in such practices.

Insurers Dictating Medications

Playing the insurance game has become an uphill climb for the patient.

Medical insurance are to help patients when in need of urgent money, but the monopoly in health insurance sector has forced us think if is good for a patient or not. The terms and conditions specified in the medical insurances forces a patient to use health services not as per needed by him but as per the requirement of health insurance companies.

WellPoint, one of the largest American health insurance companies, recently outlined treatment pathways for cancer. The company further announced that it would pay physicians an incentive of $350 per month for every patient treated as per the designated treatment protocol.

WellPoint is just one among the several insurers who are offering a positive financial incentive directly to physicians for using specific medications. This is leading to a scenario wherein patients may not get the health treatments that are best for them. Instead, they may get those which the insurance companies think might be right for them.

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