The question, whether patient engagement grows cherries or prevents sour grapes, is relevant in a health reform environment, given recent reports of an increase in patient selection of cherries. Selective health choice, which is the tendency of medical practices to selectively choose patients to treat who have fewer health problems and for whom reimbursement is better, is said to be gaining momentum as a result of the changes that link reimbursement to results and quality measures. and due to busier practice schedules and administrative burdens on physicians.

Although selective selection is not a new strategy that health insurance companies implemented for many years until the Affordable Care Act made it illegal for them to reject coverage for patients with pre-existing conditions, you will likely receive a increasing care as more patients join the network. The responsibilities of the health service delivery system and the empowerment of the patient are defined. If selective selection is truly a poison in the healthcare system, patient engagement may be the antidote, making it more possible for physicians to provide high-quality care and achieve favorable patient outcomes, replacing the financial gains.

Selective selection is not totally out of the question, as HMO health care plans, which are quite common, prohibit primary care physicians from turning away patients who have selected them as their primary providers. However, physicians have the option to terminate relationships with patients, especially if they are not inherent or do not comply with the treatment that was provided to them. In addition, physicians are free not to accept patients with other forms of insurance as long as the reason is not discriminatory on the basis of ethnic origin, creed or gender. In either case, selectively rejecting or firing a patient engenders the attitude on the part of the patient, “the grapes were bitter anyway.”

It is difficult to know at this time how prevalent patient selection of cherries is or will become over time, but it will most likely be tempered by the fact that many physicians derive great satisfaction from providing medical care. quality and experience good patient outcomes, particularly in patients who are ill. very ill with serious medical problems. By empowering patients or their caregivers with health literacy enhancement resources that allow them to participate in their health care in ways that are mutually beneficial in achieving quality improvement in health care, many will be the types of patients that doctors prefer to treat selectively. or essentially cherries instead of sour grapes.

So, going back to the original question, does patient commitment grow cherries or prevent sour grapes? The answer is probably both. After all, the fox called sour not only the grapes that he could not reach, but also those that he did reach, but had taken from him. The math will just have to unfold.

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