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- New CAP Report on Health Insurer Interference in Patient Care
On October 15, the CAP released a new report detailing how insurer interference impacts pathologists and patients. Insurer interference happens when private insurance companies dictate medical decisions to boost revenue under the guise of controlling costs. Pathologists report more of these instances in the private health sector, with insurers restricting patient-physician and physician-physician relationships by limiting the number of in-network physicians or exclusively contracting with providers and facilities. These disruptions create barriers that prevent pathologists from providing patients with the necessary care.
In the report, the CAP identified five recommendations to address insurer interference:
- Require adequate networks that include hospital/facility-based physicians.
- Restrict in-network steering/tiering and prohibit economic/cost-only network criteria.
- Maintain physician-led team-based care.
- Include regular monitoring/audits and meaningful enforcement.
- Increase antitrust scrutiny.
Download the white paper here. Watch a video statement from CAP President Donald Karcher, MD, FCAP here.