High Deductible Health Plans, a growing malpractice danger

Client: 7 Physician Clinic, Barrington, IL

Date: January 2017

OVERVIEW:

High deductible health insurance plans leave patients responsible for the first $2000 to $10000 before plan coverage kicks in and they loom as a major malpractice risk to the providers, and one that is easy to address.

THE CHALLENGE

Patients forgot or postpone care owing to costs.

Survey:

    • A 2014 Commonwealth Fund survey reported 43% of low-income respondents skipped care because of copays and out of pocket expenses

Recent Case

    • Provider follows a patient for hypertension for years
    • Patients decline a comprehensive exam to limit costs to level 2 visits
    • Pt found to have stage IIIB colon cancer that most likely would have been caught on a comprehensive physical exam
    • Due to insufficient documentation jury did not buy the argument that the patient declined needed services

THE SOLUTION

RiskAssistMD offers a solution that is specific to the high deductible plans and even includes documentation that is specific to risk management under these circumstances.

The solution is also:

    • Easy to implement
    • Inexpensive
    • Automated

The solution is centered on principles of

    • PT Notification
    • PT acknowledgment of notification
    • Clear and precise documentation

THE RESULTS

 The results of this simple solution are surprising.

    • 20% of patients comply within 2 weeks and 25% within 4
    • Clinics see increased revenue
    • A 100% of cases are Risk documented
    • Better outcomes

──── HIGHLIGHTS ────

High Deductible health plan and a medical malpractice trap

  • Patients defer or forego care timely
  • Some do, and some don’t understand risks
  • When things go sour claims originate
  • Providers often found culpable on account …
  • The solution is simple to implement
  • It results in achieving all its desired outcomes
    • Improved care
    • Better outcomes
    • Reduced cost
    • Risk mitigated
    • Increased revenue

  Clinic adoption

  • 3 RiskAssistMD clinics have adopted this solution specifically directed at these plans
  • Early results are encouraging and report
    • 20% patient compliance within the first 2 weeks
    • 25% within the first four

Customization

RiskAssistMD is able to customize these and other sections to accommodate the clinic’s special needs

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