2019 Value-based Snake Oil Award

2019 Value-based Snake Oil Award

Stephen Covey said, “ WHAT YOU DO HAS FAR GREATER IMPACT THAN WHAT YOU SAY.” – any managed care organization that SAYS that they are committed to providing value to patients but then pays patients directly for out-of-network claims deserves the Value-based Snake Oil Award.

Health systems and physicians deserve to be paid directly for their hard work. The only rationale for health plans paying out-of-network claims to patients is revenge, that is to inflict intense, severe financial pain on a health system for not agreeing to their proposed rates and terms. Arther Caplan, the Director of Medical Ethics at NYU described the practice as insane and immoral. How can a managed care executive claim their company is committed to providing value to patients when THEY KNOW that paying out of network claims to patients has:

1. Impacted the ability of many health systems to provide care affecting the patients they are currently treating.
2. Caused irreparable harm to the financial structure of many health systems which forced the community to sell or close their hospital.
3. Forced patients to travel significant distances to find an in-network provider.
4. Disrupted continuity of care for patients because they were required to change physicians.
5. Forced  health systems to pursue the patients for payment which required lawsuits and financial ruin for many patients and
6. In the worst case, patients used the funds they were paid to support their addiction (see https://www.localnews8.com/health/insurer-paid-thousands-to-addict-who-then-binged-died/1071603858)

In a recent article *, a spokeswoman for the insurance advocacy group America's Health Insurance Plans, defended the practice of insurers sending checks to patients, saying it's because insurance companies don't have "a contractual relationship in place with providers…She also took issue with the term "paying patients," saying that "reimburses" is more appropriate.” Would you like some crackers with that snake oil? Just sayin’ n8

* https://www.cnn.com/2019/03/01/health/anthem-insurance-payments-patients-eprise/index.html