I'm on ACA. I get between $100 and $150 on a gift card to do my annual PCP visit even though my premium is $0/month.

Why? Obvious if you know about the perverse incentive tqi mentions

antasvara 3 days ago | parent | next [-]

The insurance company that provides your ACA plans gets money from the government for doing so. How much money they get is tied to a few things (not an exhaustive list):

1. On average, how healthy is your group of ACA plan holders? If the group has a bunch of chronic conditions, they get more subsidy money to offset the increased care costs. Going to the PCP allows them to have official medical evidence of those conditions.

2. The government gives these plans quality ratings to help people compare them to each other. These ratings are partially based on how often patients get their annual screenings and patient satisfaction. A gift card for a PCP visit accomplishes both aims.

There are also more practical concerns. Preventative care is cheaper than an acute incident for the company. You'd rather catch an arrhythmia at a PCP appointment than pay for the cost of a heart attack.

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readthenotes1 2 days ago | parent [-]

I believe the more recent studies show that annual PCP visits actually reduce quality of health. Seems contrary, but a lot of doctors in the USA will overreact for fear of future litigation. Since most interventions have some possibility of negative consequences, it apparently adds up.

On your specific example, my understanding is that the odds are very low that a random PCP visit will detect an arrhythmia.

Of course, if you mentioned to doc that you're having fainty spells or heart palpitations, then maybe hen'll give you a holter monitor-- but then you've now increased your risk by waiting for the PCP visit instead of doing it when you first notice the symptoms.

	▲	gatlin 2 days ago \| parent [-]
		I believe you but I'm interested in the studies mentioned in your first sentence.

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EvanAnderson 3 days ago | parent | prev | next [-]

You must have very little income.

I had an ACA "marketplace" plan back for my family back in 2017 when I was self-employed. My premiums were >$15K / year for a >$10K deductible and no tax credits (because of my income).

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FireBeyond 3 days ago | parent | prev | next [-]

There are all sorts of perverse incentives in play. Many plans won't pay for weight loss drugs (obviously GLP-1s, but even beyond that) but will happily pay for gastric bypass, for one simple example.

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dd8601fn 3 days ago | parent [-]

A surgery happens once. Glp1s are forever.

$25k today or $15k/yr for 20 years?

	▲	FireBeyond 3 days ago \| parent [-]
		GLP1s don't or shouldn't cost $1K+/month. Gastric bypass surgery happens once. Many bypass patients require lifelong prescription nutritional supplements and all require lifelong lab monitoring. Ulcer risks increase severalfold. High risk of hernias, osteoporosis and complications thereof. It's not just surgery and no immediate cost. But then again, any of those issues are options for denial, so...

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dgellow 3 days ago | parent | prev [-]

Could you elaborate?