According to a recent survey by the South Carolina Medical Association, 95 percent of the physicians surveyed said they had changed the way the treated a patient based on restrictions from an insurance company.
According to the SCMA, many physicians reported pressure to change treatments based on cost consideration rather than on efficacy of treatment.
"The practices that insurers utilize are interfering with the patient-physician relationships and hinder the ability of South Carolina residents to promptly receive sufficient healthcare," said Todd Atwater, the association's CEO. "Not only do these practices discriminate against those with limited resources, but the practices are cumbersome for all parties involved. These added barriers have associated costs that are weighing down an already overburdened system"
In response to the survey, Robert Zirkelbach, spokesman for America's Health Insurance Plans, said health plans are working with providers to ensure patients are getting the right care at the right place at the right time. He told local news sources that employers are pressuring insurance companies to make sure their premiums are spent wisely.
"They're the ones struggling to cope with ever-skyrocketing costs of medical care and an inefficient healthcare delivery system," said Zirklebach. "Health plans are responding to those needs."
The SCMA is asking physicians to provide examples of instances in which they changed treatments as a result of insurance company involvement. The association intends to provide this information next year as part of an outreach campaign to citizens and state legislators.
"As South Carolina deals with the implications of the recently passed federal healthcare overhaul, it is imperative that we take a second look at pre-approval requirements, step therapy protocols and therapeutic switching policies in order to ensure that all South Carolinians have the protected relationship with their doctor that they deserve. If not, we are in danger of having medical decisions made by insurance companies rather than physicians," Atwater said.
According to the survey:
- 97 percent said they had to change a prescription medication due to restrictions imposed by an insurance company
- 89 percent agreed with the statement, "I feel that sometimes I am being pressured to prescribe a course of treatment based on cost rather than on what may be best for the patient."
- 90 percent say they don't believe communication from insurance companies to patients is accurate, fair or provides an unbiased side risk/benefit profile when communicating to patients requesting a change to their treatment as prescribed by their physician.
- 91 percent believe there should be legislation regarding restrictions that insurance companies put on physicians.
Complete results of the survey can be obtained by contacting the South Carolina Medical Association.