Medicaid, budgets and patients part two: Doctors know best
This week, we are taking a look at proposals in several states that would change the way they administer the pharmacy benefit in their Medicaid programs – transitioning from traditional fee-for-service Medicaid to a managed care model. Today we look at how these changes could place the government between doctors and their patients. Background on the issue is here.
In our first post on the managed care issue, we noted that Health Affairs raised the question of what the Medicaid managed care model would mean for patient care.
One of the biggest reasons for this question is that changing to a managed care model could limit treatment options that doctors may consider when deciding how to treat Medicaid patients. This is because of caps imposed on the number or variety of services and/or treatments doctors may consider when treating these patients.
AstraZeneca believes that as any state considers a change to Medicaid, patients under managed care programs should have the same rights and protections they currently enjoy under traditional fee-for-service Medicaid.
Without these protections, the government becomes a barrier between patients and their doctors. Medicaid patients being shifted to managed care programs should receive at least the same coverage of and access to their medicines as they previously received under fee for service.
Doctors are best qualified to determine the best treatment for an individual, and a one-size-fits-all formula doesn’t work when determining the best care.
These decisions should be based on medical history, family history, drug interactions and other factors that doctors use in concert to prescribe the right treatment for patients.
Doctors carefully evaluate many factors when deciding on treatment for a patient and combine specific patient information with their medical training and judgment to prescribe the best medicine for individual patients.
Patients and doctors often work together for a long time to find the best medicine for the individual patient.
That progress cannot be lost and the patient should not be forced to endure a new medicine based on a government rule or guideline.