Medical Confidence provides insurers with services to help their clients navigate the healthcare system. The company says this assistance enables patients to access care in a much shorter time than the Canadian average, and therefore reduces the duration of disability periods.
Angela Johnson, Founder and President of Medical Confidence, told Insurance Journal that “by improving the process and providing oversight, we reduce the wait time on average 74 days to first appointment and 235 days to treatment across all medical conditions across Canada.” She says that with respect to disability cases, the service helps to reduce claims duration by six months on average.
Frustrated and disappointed in the endless number of government pilot projects, studies and many failed attempts to address the wait times in healthcare, Johnson founded Medical Confidence in 2009. “At that time, I decided that effective change was not going to come from within the system, but rather from the users of the system. In 2019, it looks like this has proven to be right,” she said.
Individual and group insurance
Johnson said Medical Confidence provides its services to RBC Insurance, Sun Life and Manulife among others. Sun Life and Manulife use their services for group insurance, while services to RBC also include other products. “We have the Medical Confidence service on our group LTD and individual blocks so that our claimants can take advantage of getting this extra help in navigating the healthcare system,” said Cathy Preston, vice president, individual markets, RBC Insurance.
A heavy burden
Johnson observes that there is no standard process or oversight of how patients are referred to a physician specialist in Canada. “This lack of process and oversight results in long delays to receive specialist care. These delays are creating unnecessary costs insurers and employers must bear.”
She cites a recent Fraser Institute report that said each year Canadians lose a total of $2.1 billion in wages due to long waits for surgery and medical treatment. “Canadian corporations, organizations and taxpayers bear most of these losses,” she underlines.
Finding the right specialist
Johnson said one way that her firm can reduce delays is to help clients find the right specialist. Most patients access specialist care through their general practitioner and, as a result, may lose valuable time seeing multiple specialists before ultimately finding the one who has the skills they need, she said.
Johnson added that mental health and musculoskeletal issues each count for 30% of the cases the firm receives. “In musculoskeletal especially, the waiting period can reach four years in some regions where there are few specialists that have the skills needed. We validate the specialist's skills and experience and find specialists who have the optimal waiting time. If a specialist is not available in the individual’s local area and they are open to travelling, we assist them with the referral and their travel needs.
Additionally, Johnson said specialists are not given enough information about a patient’s medical history from the referring doctor. A patient may find out from his specialist that he should have had an X-ray or blood test results before meeting him. Medical Confidence focuses on determining which tests are needed before the patient goes to the appointment.