Posted by: notdeaddinosaur | September 1, 2013

Low Hanging Fruit

Insurance companies take such good care of patients — sorry, members — these days. Silly me: I thought I was the one taking care of them. But no. Nowadays, instead of paying me to take care of you, they have all these nifty programs to proactively contact you, have a nurse come to your house, go over your meds, answer your questions, and offer really cool suggestions for staying well. These are programs for people over 65, which you’d think would be a good idea as older folks tend to have more medical issues, though in fact it’s mainly so they can comply with Medicare regulations.

I have plenty of patients over 65. Many of them have lots of problems, require many medications, and would greatly benefit from this kind of case management. I’m also lucky to have more than my fair share of the very vigorous elderly. People in their 70s and older who are quite active, who play tennis every day, go biking every week, and take no meds at all.

I received a mailing from an insurance company the other day proudly informing me that they had enrolled several of my patients in one of these home assessment programs. I looked over the list. You guessed it: the only patients on it were the ones taking few if any meds, with ridiculously short problem lists, and who were plenty savvy enough to take their single pill every day.

What about the homebound double amputee who can’t read his med bottles because of his diabetic retinopathy? No luck. He’s on his own. I guess anyone they sent out to visit him would have to do something other than read through their boilerplate wellness shpiel sitting in a sunny kitchen in a nice neighborhood. They might have to wade through a laundry list of meds (more than two), and actually think about possible interactions between drugs prescribed by multiple physicians.

FSM forbid they try assessing someone who actually needs assessment!



  1. Yup, see this all the time…and just try getting a psychiatrist for any of these folks in a Medicare “Advantage” plan, think the advantage is all the insurors….

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