Pay for Performance
July 12, 2008 Updated 2023
Dr. Cate
https://drcate.com/drug-companies-bribe-...or-performance/

Your Doctor May be Paid to Prescribe Cholesterol-Lowering Statins

Do you know what a HEDIS measure is? Most patients don’t, and few doctors do. It’s a measure of how well your doctor is following certain practice guidelines. 90 percent of insurance companies grade doctors using HEDIS. And it’s important to know that these markers include getting your LDL cholesterol numbers down with drugs. If you have diabetes or cardiovascular disease, your doctor can be rewarded for following these rules. On the other hand, doctors who don’t will be financially penalized.

This is one reason why I do not work with insurance. Below this paragraph is this page as it was originally published in 2008. I’m updating it now in 2023, as it’s more relevant than ever. Why? Because the guidelines for an appropriate LDL level are even lower today than they were. I believe this is a dangerous practice for many reasons, particularly for mental health and memory.

Learn more about HEDIS measures here.

Letter to the Editor:
Penalties for Doctors Who Refuse to Sell Cholesterol Drugs

On Wednesday July 9, 2008 the Garden Island Newspaper published my Letter To The Editor with the headline above (Thank you Garden Isle)
This article is continued below...(scroll down)

I feel my patients and the people of Hawai‘i have the right to know some of what goes on behind the scenes at HMSA, our island’s number one health insurance company. This week, I will participate in a teleconference about a new initiative program created by HMSA as part of what they call “quality of care.” If you have diabetes, your doctor will be paid more if he or she convinces you to buy a cholesterol-lowering pill. How much more? If I get all my diabetics on these pills, I calculate that I may earn up to $20,000 more next year. Sounds great for me, and you might think I’d be an idiot to question such an easy cash gift. But I don’t think I’ll go for it. I don’t think there is enough scientific evidence that this practice will help all my diabetic patients, and I can’t justify such mindless, mass prescribing.
For more information on what’s happening behind the scenes, check out www.drcate.com And if you are a paying customer of HMSA, you might want to join the discussion by contacting HMSA’s vice president/medical director John Berthiaume. Catey Shanahan, M.D.
Lawa‘i

On Friday, HMSA Fired Back:
Pills recommended for a reason-- excerpt, rest at link above --

This has always been a giant money grabbing scam...

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Statins are widely prescribed to lower blood cholesterol levels and claim to offer unparalleled protection against heart disease. Believed to be completely safe and capable of preventing a whole series of other conditions, they are the most profitable drug in the history of medicine. In this groundbreaking book, GP Malcolm Kendrick exposes the truth behind the hype. He will change the way we think about cholesterol forever. Rubbishing the diet-heart hypothesis, in which clinical trials 'prove' that high cholesterol causes heart disease and a high-fat diet leads to heart disease, Kendrick lambastes a powerful pharmaceutical industry and unquestioning medical profession, who, he claims, perpetuate the madcap concepts of 'good' and 'bad' cholesterol and cholesterol levels to convince millions of people to unnecessarily spend billions of pounds on statins. Clearly and comprehensively debunking assumptions on what constitute a healthy lifestyle and diet, "The Great Cholesterol Con" is the accessible, indispensable and absorbing case against statins and for a more common-sense approach to heart disease and general wellbeing. No more over-hyped miracle drugs; no more garlic, red wine, anti-oxidants, fruit or vegetables; even a vegetarian diet is rejected in this controversial yet authoritative critique of how we have been mislead over how food and drugs affect our coronary health. Here, for the first time, is the invaluable guide for anyone who though there was a miracle cure for heart disease, "The Great Cholesterol Con" is a fascinating breakthrough that will set dynamite under the whole area.

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The Great Cholesterol Con

Thanks, Mr. Ed.