LiveLifeNaturally

Our healthcare system has changed considerably over the last 10-20 years and it is true that your physician may not offer you the best solutions to what ails you. They may be penalized if they heal you without using pharmaceuticals. The next two paragraphs is a great example on how physicians may be penalized.

"Statins offer a useful example of the conundrum faced by clinicians who want to offer lifestyle interventions. A lifestyle medicine primary care physician had a patient covered by Medicare Advantage who was diagnosed with hyperlipidemia. The patient had total cholesterol of 226 and a triglycerides level of 132. Instead of prescribing the routine statin, the physician prescribed lifestyle behavior modifications. Within 3 weeks, the patient's total cholesterol improved to 171 and triglycerides to 75. This was a great success for the delighted patient.

However, the CMS 5-Star Rating System assigned the primary care physician a grade of C rather than A, which put the physician's 5-star rating at risk. Why? Because the system bases its score largely on medication compliance. The physician was penalized despite achieving the optimal health outcome, and at a lower cost than with medication. This misalignment does not incentivize patient-centered care because it disregards patient preference, shared decision-making, and evidence-based practice."

PCPs Penalized for Positive Outcomes From Lifestyle Change Why would primary care clinicians support patient lifestyle changes when they are essentially punished for doing so? A serious quality measure misalignment is at play.