Misalignment of Incentives Is Bad for Patients, Practitioners, and Public Health
As financial burdens fall harder on individuals with lipid disorders, we dedicated one session to discussing the misalignment of incentives in cardiovascular care. There were presentations from Dr. Christie Ballantyne and Dr. Khurram Nasir.
Dr. Ballantyne focused on restoring relevancy and accuracy in alignment with scientific guidelines and LDL-cholesterol quality metrics. He highlighted the fact that current quality measures for blood pressure and diabetes are aligned to achieving specific targets but that this is not the case for ASCVD, where the measures are focused just on statin use. Dr. Ballantyne encouraged medical societies, patient advocacy groups, and individuals to engage on this topic and advocate for restoration of quality measures based on LDL-C measurement and control.
Dr. Nasir covered the financial toxicity as a barrier to cardiovascular care. He noted that overall healthcare costs can exceed $20,000 annually for people with ASCVD, with out-of-pocket spending exceeding $2,000. Dr. Nasir also presented data that one in two non-elderly adults with ASCVD face difficulty in paying medical bills and that unfortunately private insurance can actually exacerbate out-of-pocket costs.
“In our first study, what we found is that 1 in 7 families with patients with ASCVD are spending 20% of their combined income on healthcare. About 5% are spending 40% of not their income but their entire family income on this. And it's not equally distributed.”
– Dr. Khurram Nasir