Primary care physicians often provide important, cost-saving consulting, which should be covered
MONDAY, July 27, 2015 (HealthDay News) — Insurance companies should consider reviewing coverage policies to include situations where primary care physicians provide important and cost-saving inpatient consulting, according to a report published by the American Academy of Family Physicians (AAFP).
The AAFP sent letters to seven of the largest private insurers asking them to review their payment policies relating to provision of consulting services by family physicians when their patients are in the hospital.
According to the letter, some hospitals and insurance companies exclude primary care physicians from admitting their own patients, and consequently patients are admitted by hospitalists who are unaware of their history. This can result in unnecessary testing, specialty consultations, and prolonged hospitalizations, leading to increased hospitalization costs. When primary care physicians are consulted, their service is often downplayed as medically unnecessary concurrent care. Insurance companies should review and revise coverage and payment policies as necessary to cover cases where primary care physicians provide important and cost-saving consulting services.
“We believe that there is value in paying primary care physicians to see their patients in a hospital setting and that there is some evidence to suggest that doing so has benefits in terms of both improved outcomes and cost savings to the health system,” Brennan Cantrell, the AAFP’s commercial insurance strategist, said in a statement.
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