The High Cost of “Free” Incentives

The High Cost of “Free” Incentives
November 29, 2017 Ryan Robinson
Insurance benefits from Walking Mobility Clinics in Ontario

To be honest, who doesn’t love free stuff or a good deal? (Especially if we feel we got a better deal than someone else!) But when it comes to health care, an offer of something for free may come with a very high cost.

Suppliers of medical devices and services are increasingly offering incentives to entice potential clients to purchase medical devices using their health insurance benefits, even if they are not medically necessary. We have all seen signs and advertisements that offer “free shoes” with orthotics, or “free gift card with purchase” of orthotics, and that sounds pretty good initially.

The problem is, offering incentives is considered an abuse of insurance benefits and at worst can be outright fraud. The companies offering incentives must cover those costs somehow, and often it comes at the expense of the quality of the medical device dispensed to you, or inflated costs of the product or both. Offering incentives unfairly privileges those vendors and suppliers over other professionals in the minds of the public. The public sees the advertisements, receives promotions online and in the mail and assumes that’s how every practitioner does business.  What the public doesn’t know is that qualified professionals are often prohibited from offering incentives by their code ethics. Canadian Certified Pedorthists are such a profession.

Insurance providers look carefully at the costs of certain benefits and how those benefits are being utilized by plan holders. We don’t have to look very far to find examples of the high costs of insurance abuse. Investigation into fraudulent and excessive benefits claims by TTC and City of Toronto workers for orthotics and other orthopaedic products led to the firing, resignation or retirement of more than 150 employees and criminal charges being laid against more than a dozen others. That’s a very high cost for what appeared to be “free”, deals that were indeed too good to be true.

Insurance companies are now recognizing that offering incentives may signal a vendor who does not have the health interests of the client in mind. As a result, insurance companies are now starting to delist practitioners and service providers that offer incentives as a way of protecting the integrity of the plans they offer. Billions of dollars of workers’ money is being lost to insurance abuse and fraud every year, and we, the workers and employers, are paying those costs with higher premiums and more limited coverage.

Custom foot orthotics are a medical device, and ethical practitioners do a lot more than help you decide which restaurant card you want. Canadian Certified Pedorthists are highly trained foot care professionals who are governed by a very strict code of ethics. Pedorthists will perform a biomechanical exam, help educate you regarding your injury or complaint, and recommend appropriate treatment options which may include over the counter or custom orthotics, footwear, footwear modifications, bracing, compression hosiery. If you need custom foot orthotics the pedorthist will take a 3-dimensional cast of your feet and manufacture your orthotics from raw materials for a truly custom device. They will also fit that device into appropriate footwear and be available for follow up appointments, adjustments, repairs and yearly reviews.

Next time you are tempted to take advantage of a “free gift card with orthotics”, or “free lift tickets with purchase,” think carefully about the medical device you are receiving and the high cost of free.

To start working with one of Walking Mobility Clinics’ Canadian Certified Pedorthists, book an appointment at one of our many locations across Ontario.

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