In health care, you can pretty much guarantee that specialists earn more than primary care doctors. That’s what makes a new article in the journal Health Affairs noteworthy.
Researchers found that in 2013 and 2014, commercial insurers started paying primary docs a bit more — a 2 percent increase — while specialists like orthopedists took a hit of 4 percent.
The report says insurers spend nearly twice as much on an orthopedist as on a primary care doctor, and those costs increasingly are picked up by the consumer, thanks to high-deductible health plans.
University of Pennsylvania economist Robert Town says insurers want to shield consumers from that exposure.
“Insurers want two things. They want low costs and they want happy customers,” he says. “They can keep consumers happy by directing them to primary care and only see specialists when they really need to see specialists.”
Whether it works or not, you can see insurers strategy: Get primary care doctors to act like gatekeepers. That alone makes these doctors more valuable, thus the bump in pay, even if it’s modest.
The Robert Wood Johnson Foundation’s Kathy Hempstead says this approach is a hallmark of this new era.
“There should be more emphasis on prevention and wellness, and there should be less emphasis on expensive tests and procedures,” she says.
Hempstead, lead author of the report, says the real test for this primary-care-focused approach is whether it will work for people who are really sick and need the expensive tests and procedures.
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