If your health care seems fragmented and uncoordinated, here are some commonsense steps that can improve your care, and protect your health.
Work with a Primary Care Physician for Better Care
While it's common for patients to receive episodic care from a legion of different specialists that approach has been found to reduce the quality of your care. A study published in Annals of Internal Medicine reported the patients who were connected to a specific primary care physician were more likely to receive the care that was consistent with medical guidelines than the patients who were connected just to a practice.
In the study, the researchers looked at 155,590 adults in a primary care network, and evaluated how these patients received most of their care - from a primary care physician or a practice. Unfortunately, the researchers saw that patients who were not connected to a particular physician were less likely to receive the recommended care.
Specifically, these patients were less likely to complete the recommended testing for preventive and chronic illness care. This strongly suggests that having a doctor coordinate and follow-up on care plans offers you greater protection and improved health care quality.
When you're shopping for health insurance in California, be sure that your doctor is in the network. Don't rely on a medical practice where care depends on various physicians coordinating your care. Look for a primary care physician, and ask about medical care guidelines for your condition.
Use Performance Incentives to Improve Your Healthcare
Another study compared patient care from physicians who participated in a "pay-for-performance" incentive program to patient care from non-participating physicians. In the "pay-for-performance" programs, doctors were reimbursed based on the quality of care they provided.
Looking at eleven evidence-based quality indicators, such as screening for a number of different cancers, the study provided a comparison between traditional and quality-based payment assessments for a period of six years.
The researchers found a strong correlation between the quality of patient care, and whether physicians participated in a quality-based incentive program. This association became even stronger over time. The patients who saw program-member doctors exclusively during the six years experienced significantly better quality of care than the patients working with non-participating doctors.
Reimbursing physicians based on the quality of care they provide seems like a commonsense practice, but it is a novel approach in the U.S. Fortunately, it is gaining popularity within the health care sector.
Shop for Health Insurance in California that Uses Performance Incentives
Some insurance companies are pushing doctors and hospitals to provide better, lower-cost healthcare by increasing performance incentives. This helps us to move away from automatic payments to doctors for the care delivered independent of the quality provided.
Under these innovative programs, doctors are graded by insurance companies on factors like the number of patients who receive cholesterol testing, or who regularly get pap smears and mammograms. Providers who meet certain standards are eligible for bonuses.
Even though the programs are voluntary, failing to meet the standards puts doctors and hospitals at an increasing financial disadvantage. More of their potential compensation will be based on performance incentives.
Some insurance companies are looking at performance-based programs to grade thousands of cardiologists, oncologists, and other specialists. Under these plans, five to ten percent of payments could be based on how well a specialist scores.
Work with Primary Care Doctors Using Performance Incentives
Primary-care doctors will be particularly affected by this new pay structure. For primary-care physicians, some insurance companies have chosen quality performance measurements that look at the number of patients who receive cholesterol screenings, and whether diabetics' blood sugar is carefully monitored.
There is less agreement about how to grade the performance of specialists, though. Insurance companies have been reticent to look at patient outcomes, including how many patients live or die. Some insurance companies do measure how specialists adopt programs to reduce medical errors, and some hospitals are evaluated on patient satisfaction surveys.
When you're shopping for health insurance in California, consider whether insurance companies have "pay-for-performance" programs, and how may doctors and hospitals in the network participate. The quality of healthcare you receive could depend on how much research you put into finding the most quality for your investment in California Health Insurance.
By Wiley Long - President, eCAHealthinsurance.com - California's leading independent online health insurance agency specializing in individual and family California Health Insurance. Get instant California Health Insurance quotes, compare plans, apply online, and save your hard earned money!
