Defense

Physicians, Insurance Companies and Incentives

27 May , 2014  

Incentives motivate everyone.

When someone rewards us for something, we tend to do more of it. Carrots really work.

Insurance giant WellPoint is taking the idea to heart. According to an article in today’s Wall Street Journal, the company will soon start offering oncologists $350 a month for every patient on one of the insurer’s recommended regiments.

This is real money for a physician. The WSJ article quotes a doctor from the Cleveland Clinic saying the payment “…is not something we’d ignore.”

I suspect WellPoint isn’t doing this just to help patients; the company is trying to save money.

It is safe to assume that WellPoint’s regiments won’t include aggressive use of the most expensive therapies. The company will likely encourage physicians to stick with effective and inexpensive drugs.

This sets up a conflict between an oncologist and her patients. Does the oncologist use a therapy with modest efficacy that complies with WellPoint’s guidelines and preserves the $350 per month payment? Or should she try a newer therapy that might work better and take the financial hit?

Incentives in healthcare are complicated.

When making a treatment decision, remember that insurance companies and physicians are motivated by many incentives and the only people 100% committed to your health are you and your loved ones.

 


One Response

  1. davetuchler says:

    re: Wellpoint — I’d be interested to know if payment is in any way linked to results or even compliance, rather than just prescribing the program.

Leave a Reply

Archives

Conversation Across the Site

  • David Rose { This sounds very very difficult. You put alot of energy into it and obviosly care. I would suggest you focus on the room and let... }
  • M E Lesniak { I think you picked the wrong hill to stand on. You work at one of the most expensive degree factories in the country and I’m... }
  • Stephen Calkins { Forgiveness based on income? What if it is a wealthy family that figured borrowing cheaply was a good deal, but there is massive wealth? What... }
  • Todd Holscher { Transparency in pricing is a very good idea. Students will still susceptible to the influence of marketing and advertising by colleges, but it’s the right... }
  • Emita Hill { Vast sums of money. Alternatively provide more support to state schools so they can lower tuition and maybe to privates strictly for scholarships. }
  • David Rose { Tim, I dont think your views are balanced. You obviously are being paid by these loans. The money has been given to your university and... }
  • Read more Comments »

Collaborate with Tim

Tim helps companies around the world build great brands. To schedule a program or event click here. To learn more about Tim’s books, click here.