Care based on a collaborative, patient-centered approach, continuity and the availability of medical information is important for all patients. It is essential and life-saving for those with serious or chronic conditions like cancer, inflammatory bowel disease or multiple sclerosis.

The insurer Anthem Inc. has enacted a new policy for Maine, to take effect March 1, that will gravely disrupt patients’ ability to make decisions on their own health care by limiting advanced imaging in the hospital setting for patients. Instead, patients must go off-site and schedule their MRI or CT imaging services at independent imaging centers. Anthem will deny financial coverage for scans done in the hospital setting if the insurer deems that the scan could have been done off-site.

There are serious problems with the proposed policy, beginning with the fact that it will interfere with the basic decision-making process between patients and their clinicians (physicians, nurse practitioners and other professionals).

Anthem’s new policy will also disrupt trusted collaboration between clinicians and radiologist partners, the timely scheduling of patients’ imaging and follow-up appointments and the effective transfer of patient registration and medical records.

We understand Anthem’s motivation is to help control costs in America’s increasingly expensive health care system. Unfortunately, this attempt to contain costs misses the mark and prioritizes cost over value. This policy could even increase both human and monetary costs in the long term if patients could miss follow-up appointments or diagnostic errors occur.

Patients must be drivers of their own health care and must have a voice in choosing where they receive needed or recommended services. Clinicians must be allowed to recommend the most medically appropriate services for their patients. We strongly encourage Anthem to rethink this policy and instead work with patients and clinicians on mutually beneficial solutions that put patients first.

Peter Elias, M.D.

board member, Society for Participatory Medicine