http://www.letstalkhealthcare.org/care-management/the-cost-of-non-compliance/ Tue, 06 Jan 2009 23:18:54 +0000 http://wordpress.org/?v=2.5.1 http://www.letstalkhealthcare.org/care-management/the-cost-of-non-compliance/#comment-5855 Charlie Baker Sat, 06 Sep 2008 18:59:58 +0000 http://www.letstalkhealthcare.org/?p=256#comment-5855 Sean - good post. As you may or may not know, Harvard Pilgrim does a lot of member outreach - using mail and phone communication - to encourage our members who need to seek screenings and other tests to go get them. And we usually chase them more than once. This is exactly the right role for the plans - encouraging their members to comply with "best practice" standards concerning preventive care - thereby supporting the work being done by the PCP. That's one of the reasons we believe our member compliance scores on national standard tests are so high in all three states we serve, even though each has a different network of providers. Sean - good post. As you may or may not know, Harvard Pilgrim does a lot of member outreach - using mail and phone communication - to encourage our members who need to seek screenings and other tests to go get them. And we usually chase them more than once. This is exactly the right role for the plans - encouraging their members to comply with “best practice” standards concerning preventive care - thereby supporting the work being done by the PCP. That’s one of the reasons we believe our member compliance scores on national standard tests are so high in all three states we serve, even though each has a different network of providers.

]]> http://www.letstalkhealthcare.org/care-management/the-cost-of-non-compliance/#comment-5834 sean grady Thu, 04 Sep 2008 14:53:18 +0000 http://www.letstalkhealthcare.org/?p=256#comment-5834 Charlie - As you know, in eastern Massachusetts most physicians are currently in some model of "pay for performance" where non-compliant patients can cost physicians (especially PCPs) thousands of dollars in annual incentives. I have seen first hand a PCP that wanted to send a letter to her non-compliant mammography patients telling them that they were costing her thousands of dollars every year by not having their annual test. This letter never went out but it does a good job illustrating the level of frustration physicians have with patients that join their panels and do not do what is expected of them. None of the pay for performance metrics seek 100% compliance but when many of these financial incentives come down to just a handful of non-compliant patients you can see why physicians get so upset. Frankly, many physicians feel it is not their job to drive the patient to the office to be seen and to have the required work done. Letters are sent and reminder calls are made but at what point does this responsibility fall to the patients to get to the office to be seen? Physicians should not be held financially accountable for diabetic patients that refuse to come in to be seen by a willing PCP. This all goes to the bigger issue of personal responsibility that seems to have gone missing in today's society. Charlie - As you know, in eastern Massachusetts most physicians are currently in some model of “pay for performance” where non-compliant patients can cost physicians (especially PCPs) thousands of dollars in annual incentives. I have seen first hand a PCP that wanted to send a letter to her non-compliant mammography patients telling them that they were costing her thousands of dollars every year by not having their annual test. This letter never went out but it does a good job illustrating the level of frustration physicians have with patients that join their panels and do not do what is expected of them. None of the pay for performance metrics seek 100% compliance but when many of these financial incentives come down to just a handful of non-compliant patients you can see why physicians get so upset. Frankly, many physicians feel it is not their job to drive the patient to the office to be seen and to have the required work done. Letters are sent and reminder calls are made but at what point does this responsibility fall to the patients to get to the office to be seen? Physicians should not be held financially accountable for diabetic patients that refuse to come in to be seen by a willing PCP. This all goes to the bigger issue of personal responsibility that seems to have gone missing in today’s society.

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