By Adam Kroeger, Truss
Client Executive, Benefits
“Hospitals look at primary care as loss leaders to act as feeders. They are more interested in sick patients filling hospitals than well ones being well managed by primary care.” –Jordan L. Shlain, M.D.
I recently visited Valvoline with my “$15 Oil Change” coupon in hand, feeling pretty great about myself. My wife always gives me a hard time about not using coupons when I go shopping, and this was finally my chance to show her how financially responsible I’ve become. Common sense probably should have told me that four quarts of oil and a filter would cost around $25, but I was anxious to pay my $15, and go home. Sipping on lukewarm coffee and watching “The Price is Right” in the waiting room, I stood up as the mechanic called my name. Imagine my surprise when he pulled out a clipboard and said:
“Mr. Kroeger, did you know your windshield wipers need to be replaced?” My heart sank.
“… and you need a new serpentine belt,”
“… and your coolant needs to be flushed.”
And you get the picture. Before I knew it I was $225 in the hole!
Does this story sound familiar? You buy cheap products all the time that lead you into opportunities to buy more expensive products. We call these cheap services, loss leaders.
Unfortunately, we have loss leaders in healthcare as well: Primary Care Doctors. Primary Care Doctors are the “$15 Oil Change” of the medical industry. Especially those that work for major hospital systems. As profit margins have shrunk over the years, doctors have been forced to rely on their ability to recommend more expensive services to bring in income.
This type of incentive system causes an incredible amount of wasteful, unnecessary care. It’s estimated that as few as 44 percent* of all knee replacements are considered “appropriate”. Patients who receive physical therapy have better outcomes and higher satisfaction than those who go under the scalpel.
There is a solution
There are several simple ways around this expensive and wasteful issue. Here are just a few:
- Always require a second opinion from an independent outside physician. Independent physicians have no incentive to recommend unnecessary, expensive services. This is because they are an unbiased third party and they do not work for a hospital system. Independent physicians will use clinically proven recommendations to get the greatest results for the patient.
- Add an on-site or near-site health clinic. Having an independent clinic that employees have access to is a fantastic way to influence employees to receive inexpensive primary care without the incentive of a large hospital system.
- Use a Direct Primary Care provider. Direct Primary Care providers are an alternative to the typical “fee for service” models where doctors are forced to rush from patient to patient. Patients typically pay a monthly, or annual fee, and all primary care services are on retainer.
At Truss, our proven money-saving strategies can be seamlessly inserted into a healthcare plan with little to no employee disruption. For more information, please contact Adam Kroeger at 913-312-5955 or firstname.lastname@example.org.