A survey of primary care doctors found that less than half felt ready to discuss medical budgets and reported low knowledge of how HSAs work.
If physicians don’t understand how high-deductible plans work, how can patients?
One problem is that there is no formal training. I learned pretty much everything I know about the various types of insurance plans and basic health policy issues from reading blogs. Not every doctor does so.
Another is that a typical doctor’s office accepts upwards of 10 different insurers, each with their own byzantine rules. Knowing the nuances between each plan is a lot to ask, especially when schedules are overflowing with patients.
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- My take: Dwindling primary care, spinal care, ratting out patients
- How the primary care doctor shortage threatens Obama’s health reform plan
- Primary care and the elderly
- How primary care needs to change
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HSAs, with a HDHP and funding of the deductible into the HSA by the employer, represent our best hope for reducing unnecessary testing and low value treatments by putting the patient in charge of the money. We’re seeing more of these this year at our office.
However, many docs are uncomfortable with leaving the fantasy world where cost of tests and treatments doesn’t matter. HSA patients ask harder questions of their physicians, “Doc, do I really need this test”. Patients with HSAs are demanding more of their generalists physicians than just a bunch of lab slips, x-ray orders, and referrals.
It’s good to see and something we, as a nation, need to do more.
The HSA with HDHP concept is a good one, but they were rolled out before other necessary steps were taken. We need cost and quality to be more transparent, reduction in unnecessary complexity in the system, and better education on the front end about how HSAs work and how the patient and provider responsibilities change as a result.
anonymous – I think HSAs will help with the issue of excessive testing, but I wouldn’t call them the best hope. Reducing physician fear of litigation, further reducing financial incentives to order tests, and further developing a evidence-based standard of care to guide practitioners have to rank pretty high on that list.
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