Episode 8: Who is Really Calling The Shots When It Comes Patient Care

Send us Fan MailA survey of 600 doctors found that 89% said they no longer have adequate influence in the healthcare decisions for their patients. 87% reported that health insurers interfere with their ability to prescribe individualized treatments.The survey also found that because of their frustration, many doctors said they are thinking of leaving the profession and would not recommend a career in medicine to others.And the bottom line is this…some medical professionals feel angry and frustrated knowing that unqualified insurance company personnel have the power to override their professional judgment and that the long-term health of their patients is being compromised so health plans can achieve short-term cost savings.Who is in charge of your care?  Now the obvious answer is your provider. In most cases this is true, but what is also true is there are sometimes restrictions with the prior authorization process that your provider is required to follow per health insurance companies’ guidelines. Health Insurance companies may put into place a rigid prior authorization process that requires limits to the procedure or medications that may be used for your condition. What we will discuss: 1)    Who is in Charge of Your Care?2)    Discuss the Prior Authorization Process and Step Therapy and How it May Control the Care You Receive.3)    Do you have Options?a.     Straight Talk with your providerb.     Appealing your Insurance Companies Decisionc.     For medications…Biosimilars – what are they and are they the answer to patient equity and access?Resources:Who’s Calling the Shots? Doctors Worry About Insurers Overriding Their Treatment DecisionsWhat is Step Therapy? How to Get Insurance to Pay for Your Non-Preferred DrugHow Access to Biosimilar Drugs Could Boost Healthcare EquityPrior Authorization: Overview, Purchase, ProcessBiologics vs. Biosimilars: Key Differences ExplainedSupport the show