If time is money, this is what @Cigna thinks the health of its members is worth: 1.2 seconds
It’s not just @Cigna, it’s all the big insurers — @UHC@AnthemBCBS@Aetna - multiple lawsuits filed for the amount of denials they have, but it’s more profitable for them to rampantly deny claims and settle the class action lawsuits later than it is to just do the service they… twitter.com/i/web/status/1…
Don’t be fooled — the stars of these healthcare insurers are not the doctor “peers” they employ, it’s the lawyers, lobbyists and finance teams that create the vision of paying as little as possible for healthcare of its members while collecting the most premiums.
This was not @Cigna, but all the big insurers have these internal “algorithms” to deny as much as possible. Sadly, they aren’t even rooted in @CMSGov rules for CPTs. They’re playing a game where they set the rules and neither patients or doctors can ever win.
In fact, they literally count on patients not ‘winning’ and being too downtrodden to fight it (after all…they’re probably worn down and weakened, having, y’know only recently been sick/hospitalized…)
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New generation of US #doctors show progress, by @AAMC study on residents and fellows, 47% total female, #gensurg 46%, #radiology still only 27%, #emed 39%…
Based on the @StanfordMed graphic, we can assume why progress for gensurg but why not for Rads…
So what are #PBMs? Chances are, if your meds suddenly got changed by your insurer, or you’ve been waiting weeks on #priorauth for a med you need, or you pay $$$$$ for a drug in the US that is cheap overseas, you’ve already experienced a #PBM and didn’t even know… twitter.com/i/web/status/1…
That’s b/c #PBMs aren’t meant to be known, they’re meant to be a middleman in healthcare cutting in an extra layer of profit for them and an extra cost to you…wonder why #prescriptiondrug pricing makes no sense compared to prices in other countries? This is why.
Pharmacy Benefit Managers (PBMs) are third party entities paid by healthcare insurance companies to manage all things meds: the formulary (what is/isn’t covered), the price from manufacturer, and the cost (copay or “tier”) to the patient.
We have high c-sx rates, low prenatal care, high chronic disease rates in our mothers. Post-partum care is a single visit at 6 weeks. Working pregnant moms may opt to induce labor for the 'convenience' of optimizing their leave...
Speaking of leave, the US is the one of the ONLY industrialized countries to NOT have ANY paid parental leave. If that doesn't reveal value in a society, I don't know what does. Punchline: the value isn't in family. No wonder our divorce rates and rates of mental health and… twitter.com/i/web/status/1…
#womenshealth is #disparate because medicine evolved in a patriarchal society. Male presentations of disease are “typical”, female ones are “atypical”. Society becoming more #gender#equal, doesn’t undo the historical bias of medicine we still rely our practice on - as a result,… twitter.com/i/web/status/1…
While #postpartum care is an obvious example. @American_Heart published that women don’t classically present with chest pain like men in heart attacks, but instead may have fatigue or insomnia. This can be easily written off by doctors as “stress” ahajournals.org/doi/full/10.11…
“Stress” is a generous explanation I hear of writing off symptoms. More commonly, I hear “dramatic” or “being extra” as explanations. Those aren’t ICD codes, but implicit biases disproportionately assigned to female patients.
Great 🧵- my takeaway since having a 👶🏻myself: if a patient comes to the ER postpartum, DO NOT BLOW THEM OFF. The barrier to leave the house is so high, that if they put on pants to come to the ER, they NEED something. HELP.
Women’s symptoms are often seen as histrionic or atypical at baseline by a medical system grown in patriarchy. Postpartum is one of the most vulnerable times in a woman’s life, so if they seek help, do so, without judgement or barrier.
The issue may be social or a knowledge gap or a lack of healthcare access, but it’s our duty to counsel/reassure/coordinate just as much as it is to treat a classic medical complaint.