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United Healthcare Drinks the Kool Aid (Insureblog)
“UnitedHealth Will Tie Doctors’ Payments to Quality of Care in U.S. Shift” was
the headline I saw during my morning review of medical news. The article
describes in glowing terms how United Healthcare will save money because
people will be healthier.
“UnitedHealth expects to save twice as much as it would spend on incentive
payments for doctors because patients will be healthier, according to company
documents ... The nationwide expansion of the program follows similar efforts
by the U.S. government and rival insurers to trim medical costs by shifting
away from paying based on the amount of services provided.”
The age-old argument of quality over quantity. Currently, the payment system
in place is quantity. Providers are paid per CPT code billed, which defines
either an office visit or a procedure performed. Medical notes, referred to as
SOAP(S=Subjective, O=Objective, A=Assessment, and P=Plan) notes do not mention
quality of care, only that care was delivered and the plan (if any) for
continued care. The current guidelines to writing a SOAP define the exam, the
chief complaint, what was examined, diagnosis and treatment. In situations of
a chronic condition the provider can note if the patient is getting better ...
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