Blue Cross Colonoscopy Policy Debated
The San Francisco Chronicle on Thursday published two opinion pieces presenting opposing views of a new Blue Cross of California policy that will take effect July 1. Under the policy, Blue Cross will reduce by 20% payments to physicians for colonoscopies performed in hospitals and increase physician payments to 5% above standard fees when colonoscopies are performed in physician offices or ambulatory surgery centers (California Healthline, 6/29). Summaries appear below.
- Jeff Kamil, Blue Cross chief medical officer: "Most sectors of the American economy are based on the rational laws of supply and demand," but "[h]ealth care is not among them," Kamil writes in a Chronicle opinion piece. According to Kamil, it is "not uncommon for a wide variation in prices" between care providers, and "there is no harm" in offering doctors incentives to provide lower-cost, preventive care. Critics who "unfairly derided [Blue Cross] on the false assumption it had induced its physicians to make medical decisions based on financial considerations rather than what is in the best interest of their patients" could not "be further from the truth," Kamil writes, noting several exceptions to the policy (Kamil, San Francisco Chronicle, 6/29).
- Emmet Keeffe, chief of hepatology at Stanford University School of Medicine and co-director of the Stanford University Medical Center liver transplant program: Keeffe, in a Chronicle opinion piece, writes that he is "alarmed" by the Blue Cross policy change because it "may not be medically appropriate, nor in the best interest of the individual patients, to perform certain endoscopic procedures" in an ASC. According to Keeffe, "As doctors, we should have the final say as to how to best care for and treat our patients." Doctors "should not be beholden to insurance companies or other outside organizations to dictate how we practice medicine," Keeffe writes, citing opposition from gastroenterology groups (Keeffe, San Francisco Chronicle, 6/29).