Healthcare Lie 1: Risky Patients Only Raise Rates

The following post is an excerpt from our white paper: 7 Lies We’ve Told Ourselves That Prevent Us From Fixing Healthcare. Download the whole white paper today to learn more.

If you’ve been paying attention to the healthcare debate at all, you’ve heard a lot about high-risk patients. Insurance companies say they’re the ones that make health insurance coverage unaffordable for everyone else.

Some propose creating high-risk pools that will move the riskiest patients into alternative buying groups so they won’t impact everyone else’s premiums. But such a move does nothing to solve the underlying problem that is driving costs higher every day: high-risk patients need help!

Even worse, our system creates more high-risk patients every day. With more and more people forced into high deductible insurance plans, the more people there are who wait until they have a major issue to visit the doctor. They’re not getting the routine care they need to become and remain healthy, and therefore become riskier patients every day.

7 LIES We’ve Told Ourselves That Prevent Us From Fixing Healthcare

We constantly talk about fixing healthcare, but we lie to ourselves about what’s driving our system’s flaws. The result is that our self-deception prevents us from seeing what’s really going on, and guarantees we’ll keep making the same mistakes. In this white paper, we take on seven of those mistakes, and the lies that are driving them.

Here’s the secret: when primary care is provided as a capitated cost, high-risk patients can come to the clinic as much as they want without the employer or insurer incurring any more costs.

Vera offers primary care at a fixed cost to employers and health insurers. When a Vera clinic is installed by an employer, there’s a specific type of person that typically comes to the clinic first. You guessed it: high-risk patients.

The results are stunning. In a recent analysis of five Vera clients, annual medical cost trends prior to partnering with Vera were increasing at an average of 15.20%. After Vera, those trends decreased to an average of just 5.35%. The client with the biggest drop saw their trend go from 26.42% to 1.07%.

The conclusion is clear. Rather than marginalizing high-risk patients, we should increase the primary care provided in a fixed-cost environment — especially when that environment allows providers to manage their care and reduce wasteful specialty care.

To learn the rest of the 7 lies we tell ourselves that prevent us from fixing healthcare, download our latest white paper today.

This blog is part of a three part series. 
Read Part 2 — Lie 2: Access Drives Overuse
Read Part 3 — Lie 3: Wellness Programs Only Reduce Costs For Those Who Are Involved In Them