More good news for low-quality health plans

A new study in the January, 2002 issue of the Journal of General Internal Medicine should warm the hearts of executives of low-quality managed care plans.  Investigators from the AMA Institute of Ethics report that doctors encourage their sicker patients to stay away from capitated HMO plans, and instead push them toward fee-for-service plans.

The doctors' reason for doing so, according to the study, is their concern for the quality of care their sicker patients receive in many capitated plans.  Their belief that their patients who need medical care are better off in less restricted health plans leads them to urge their patients to avoid capitated plans.

DrRich comments:

By steering their sicker patients away from lower-quality health plans, and by not steering their healthy patients away from them, doctors are assisting these plans in achieving one of the necessary goals of their business plans, i.e., cherry picking. So, ironically, doctors are increasing the longevity of such low-quality plans.

DrRich doubts that managed care administrators predicted this "help" from doctors, since such a prediction would have to assume a certain amount of altruism on the part of physicians, and most managed care administrators seem to hold doctors in too much contempt to attribute such a beneficent trait to them.  The doctors' assistance of these managed care plan is, as are many of the good things in life, entirely serendipitous.

February, 2002

Back to news and commentary

YourDoctorintheFamily.com Home Page