Health Insurance Restraints

Three obstacles that some patients face when obtaining routine healthcare that a care coordination provider addresses are financial restraints (including lack of health insurance), no access to medical advice from a professional, and lack of preventative care, which results in escalation of the patient’s medical problem. The first obstacle which is financial restraints/health insurance restraints is discussed in the article ‘The Hot Spotters’, which discusses the story of a man who stopped refilling his medications because he could not afford the co-payment that his insurance required. The article states “The man, dealing with higher co-payments on a fixed income, had cut back to filling only half his medication prescriptions for his high cholesterol

Provide an example of how a “health coach” can help bridge the gap in the coordination of care for a patient with complex medical problems, and two reasons stated in the article why a patient may be more receptive to a health coach vs. a healthcare provider.

A “health coach” can help bridge the gap in the coordination of care for a patient with complex medical problems in many ways. These health coaches can provide knowledge and support for patients who do not know how to properly manage their diseases/medical conditions. These coaches can also encourage patients to cut out bad habits (ex. Smoking) that cause their medical conditions to escalate. Health coaches can be extremely helpful in providing preventative care for patients that need guidance and assistance. These coaches are trusted individuals who are used connect with patients and help them. Patients may be more receptive to health coaches vs a healthcare provider because “Most of the coaches come from their patients’ communities and speak their languages.” This allows patients to trust and confide in their health coach. (Gawande, 15). Health coaches also spend more one-on-one time with patients which allows for a trusting relationship as opposed to a ten minute meeting with a healthcare provider. Additionally health coaches are trusted individuals that are recruited to connect with the patient and advocate for their health. Health coaches are focused on the patient and healthcare providers typically have a specific

One reason is that preventative care would decrease the amount of patients a doctor sees, which results in less need for emergency care providers. This would cause job demand to decrease and may cause a decrease in salary as well. This is because there would not be as many patients and without the large bill that each patient pays the hospital/insurer would make less money and thus the doctors would experience a pay cut as well. An example was discussed in the article where a doctor had a women return for checkups multiple times a year and when she was encouraged not to go because she was not experiencing medical issues the doctor reached out to her to come back for unnecessary checkups. (Gawande,