/r/medicine: a subreddit for medical professionals

5% of patients account for 48.8% of total US healthcare spending, 1% account for 20.7%

https://meps.ahrq.gov/data_files/publications/st540/stat540.shtml The most commonly treated condition among the top 5 percent of spenders in 2019 was hypertension (46.2 percent), followed by osteoarthritis/other non-traumatic joint disorders (44.5...

Prior authorization isnt utilization management anymore. Its unpaid clinical labor.

I spent almost an hour yesterday getting a prior authorization pushed through for a medication the patient has been stable on for two years, and...

Low health literacy: patients don't know how many pills they're taking each day?

Im reading an article on uptodate on "Heart failure: Self management". One passage reads: -- For instance, while 71 percent of low-literacy patients in one study could...

Insurance companies now stating Peer-to-Peer's are now "for educational purposes only" and if you want to an appeal a decision the PATIENT (not the doc) has to initiate and go through the formal appeals process themselves.

Has anyone else experienced this? It's absolutely insane. As if peer to peer wasn't ridiculous enough now they are doing away with the system entirely...

/r/medicine: a subreddit for medical professionals

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5% of patients account for 48.8% of total US healthcare spending, 1% account for 20.7%

Prior authorization isnt utilization management anymore. Its unpaid clinical labor.

Low health literacy: patients don't know how many pills they're taking each day?

Insurance companies now stating Peer-to-Peer's are now "for educational purposes only" and if you want to an appeal a decision the PATIENT (not the doc) has to initiate and go through the formal appeals process themselves.