IU study on overuse of specialty care

In a recently-released report by the Indiana University Center for Health Policy it was suggested that Hoosiers use specialists too often and it increases medical costs. The report also supported the medical home concept as a means to contain health care spending.

The health care home model is virtually the same as the primary care physician but it emphasized more control of the PCP. The PCP would coordinate and oversee all aspects of that patient’s care as well as coordinate visits with specialists. This is the way it should work anyway but there is not enough time or reimbursement to primary care doctors to make this feasable.

The study showed that in Indiana, patients tend to see a specialist without first consulting a primary care physician. The study noted that the state has more specialists than the national norm, and a shortage of family doctors and pediatricians which leads to the increased utilization of specialists.

It also showed that medical students in Indiana are increasingly choosing to specialize rather than enter primary care further impacting Indiana’s shortage of primary care physicians. The report showed that increasing reimbursement for primary care physicians and other primary care providers would help attract additional students to enter primary care.

But when you see Indiana legislators failing to address the problem, there is little hope of much change. The Medicaid rates in Indiana have not increased for more than 15 years even though every other aspect and cost of medicine has dramatically increased.

The problem is well-known, but the actions from legislators has been dismal. If insurance were used as it was intended and not for every aspect of care, things would change. When patients have more financial liability in the process, they make better value decisions.