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Study:Primary care costs, reimbursement low

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Government Accountability Office (GAO)

Primary care costs much less than specialty care, but insurers aren't necessarily taking that into account, according to a new study. The study, by HHS's Agency for Healthcare Research and Quality, noted that while orthopedist fees averaged $210 per visit, and cardiologists $232 per visit, primary care physicians typically charge $100 per visit. But insurers still penalize primary care, requiring patients to pay an average of 20 percent of PCP costs out-of-pocket. Despite higher costs, specialty co-pays were lower, the AHRQ found. For example, insurers only required consumers to pay 16 percent of orthopedist fees and 13 percent of cardiologist fees. These results are a bit of a surprise, given that health plans have every reason to encourage prevention-oriented primary care treatment. Sounds like it's time for some benefits tweaking.

To find out more about the study:
- read this United Press International article

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