<p>JWR:<br>
As a practicing physician, I would like to alert your readers to a new policy which we are beginning to see from our insurance companies. As these companies become increasingly paternalistic, it is important to keep abreast of just what they are requiring, especially since most of these policies are invisible from the subscribers’ viewpoint. What we are seeing specifically is a policy under which we (the physicians) are penalized if parents opt out of vaccines, check-ups or follow-up visits. </p>
<p>The key here is that if you opt to follow a vaccine or check-up schedule that differs from that which your insurance company recommends, they will decrease my reimbursement for the entire panel. This means that if you have Anthem insurance (for example) and decline your chicken pox shot, we are at risk of losing up to 1% of our reimbursement for every patient who has the same insurance. At my practice that is roughly 50% of my patients. That may not seem like a lot, but here it would amount to about $15,000. Multiply that by every vaccine which is declined. The result will be that if you opt to vary from the schedule your insurance company "recommends," we would ask you to seek your care elsewhere. This is wonderful from the insurance company’s viewpoint because it <strong>makes us the bad guys</strong>. </p>
<p>Please review your policy for this kind of "incentive." While I am very supportive of vaccination and check ups, I also feel that it is not my job to be an enforcer, but to be a partner and educator. It is these kinds of policies that are driving good folks out of the medical field. – Peds Doc in Virginia</p>