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How do the decisions that patients and their doctors make impact insurance plans?

Although health insurance plans set their own guidelines for coverage, patients and doctors do have an impact on their outcomes.  Physicians have an ethical responsibility to provide the most appropriate care to their patients.  Doctors’ decisions and recommendations directly impact health care costs.  Physicians who spend less time with their patients and circumvent an extensive review of their medical background may rely more on diagnostic tests.  This decision ultimately increases medical expenses billed to the insurance company. 


Patients directly impact insurance plan expenditures through their personal healthcare decisions.  Patients who select to participate in preventative measures and make healthy decisions ultimately reduce their medical costs, and therefore their insurance coverage expenses.  On the other hand, patients may also increase their medical costs.  A recent study found that patients who participated in their medical decisions actually spent more time in the hospital.  Patients who are well-informed and research their medical conditions may select the newest treatment options, which are often more expensive.  Patients are also now relying on more drug treatment options, increasing the burden on insurance plans. 


Both patients and doctors can negatively, as well as positively, impact insurance plans and their bottom lines. 

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