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.
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.