Lie 2: Access Drives Overuse

The following post is an excerpt from our new white paper: 7 Lies We’ve Told Ourselves That Prevent Us From Fixing Healthcare. Download the whole white paper today to learn more.

In his recent book Factfulness, Hans Rosling write:

“Under the current US system, rich, insured patients visit doctors more than they need, running up costs, while poor patients cannot afford even simple, inexpensive treatments and die younger than they should. Doctors spend time that could be used to save lives or treat illness by providing unnecessary, meaningless care. What a tragic waste of physician care.”

If you don’t read closely here, it appears that Rosling is making the case against overuse. He in fact is making the case against the prevailing care business model, a fee-for-service system that compensates provider organizations on the total number of patients seen and treatments provided. Rather than address a patient’s whole health, including finding out the real basis for the complaint that brought them in, primary providers refer patients to specialists for treatment.

Our experience (and data) backs up this assertion. Usage isn’t the problem. Our data shows that there is a demonstrable reduction in costs when a patient comes to a Vera clinic just one time. In fact, our analysis of a client with 4,066 employees revealed that the total medical costs of those who used the clinic were $1,488 less per member per year than patients who didn’t utilize the clinic. And, the more time they spent with providers, the more costs dropped.

7 Lies We’ve Told Ourselves That Prevent Us From Fixing Healthcare

We constantly talk about fixing healthcare, but we lie to ourselves about what’s driving our system’s flaws. It begins with the fee-for-service business model. In today’s standard production-based approach, providers are compensated on the number of patient visits. Keeping patients healthy financially punishes caregivers.       

The result is that our self-deception prevents us from seeing what’s really going on and guarantees we’ll keep making the same mistakes. In this white paper, we take on seven of those mistakes and the lies that are driving them.

But there’s a key to why increased frequency drives lower costs with Vera. It’s called a comprehensive care plan inside of a fixed-cost environment. Vera’s care teams develop this plan based on a patient’s health goals, then use it to guide all of their future care. When a primary care provider offers the level of overall routine care patients need, any necessary referrals result in better qualified patients for treatment. Specialists can practice at the top of their license, while primary providers experience greater satisfaction in their roles.

So, in an advanced primary care model like Vera, when a patient comes into the clinic more, it isn’t for superfluous reasons. They know they’re coming to see us to help them move toward their health goals. The result: reduced costs and healthier patients.

To learn the rest of the seven lies we tell ourselves that prevent us from fixing healthcare, download our latest white paper today.

This blog is part of a three-part series.

Read Part 1 — Lie 1: Risky Patients Only Raise Rates
Read Part 3 — Lie 3: Wellness Programs Only Reduce Costs For Those Who Are Involved In Them