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News on the state's largest health insurers; the effects of health care reform on coverage; rising premium costs.

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Dartmouth Study Looks At When Doctors And Patients Clash Over ‘Unnecessary’ Care

A new Dartmouth study looked at whether or not doctors' actions are influenced by an interest in controlling health care costs. (Alex Proimos/Flickr)

A new Dartmouth study looked at whether or not doctors’ actions are influenced by an interest in controlling health care costs. (Alex Proimos/Flickr)

What happens when you want a test that your doctor thinks won’t help? Has a national campaign against high-cost, low-value care helped physicians have these tough conversations? And what drives doctors to provide care that they don’t think a patient needs?

These are the sorts of questions that researchers at the Dartmouth Institute for Health Policy and Clinical Practice sought to answer in a new study that came out Tuesday. The researchers surveyed clinicians at Atrius Health, Massachusetts’ largest outpatient care provider, with over a million patients, to determine what drives physicians to order tests they don’t think are in a patient’s best interest, and whether doctors were interested in controlling costs.

While nearly all doctors (96.8 percent) in the survey agreed that they should “limit unnecessary tests,” one in three thought that it was “unfair” to ask physicians to consider cost, and nearly one in three (30.7 percent) thought there was too much emphasis on cost. Primary care doctors were more likely to report being pressured by patients to order unnecessary tests, while surgeons were more likely to be concerned about malpractice.

Dr. Tom Sequist, one of the study’s authors, said in an interview that the researchers found a big gap between physicians’ desire to limit costly and low-value care, and their ability to do so.

“The thing that strikes me the most about this study is that over 90 percent of physicians said they were interested in reducing unnecessary cost, but only a third said they understood the role of cost in the system,” Sequist said. “It’s like saying, ‘I’m really interested in physics, but I have no idea how physics works.’ ” Continue reading

Josh Archambault: Paternalism Undermined Mass Health Reform Law

One of a series of analyses on the 10th anniversary of the 2006 Massachusetts health care overhaul. Josh Archambault is a senior fellow at the Pioneer Institute and is co-author and editor of “The Great Experiment: The States, The Feds and Your Healthcare,” a comprehensive review of the Massachusetts state law. He also served in the Romney administration. Continue reading

John McDonough: Mass. Carved The Path, But More Needs To Be Done

One of a series of analyses on the 10th anniversary of the 2006 Massachusetts health care overhaul. John E. McDonough teaches at the Harvard T.H. Chan School of Public Health. In 2006, he was executive director of Health Care for All in Massachusetts. Between 2008 and 2010, he worked in the U.S. Senate on writing and passing the Affordable Care Act.   Continue reading