Cracking The Medical Second Opinion Market Code 2022

Cracking The Medical Second Opinion Market Code 2022

The Global Medical Second Opinion Market by geography into – North America, South America, Europe, Asia-Pacific (APAC), and Middle East

2020-12-28

Most people experience at least one diagnostic error in their lifetime, and sometimes these errors lead to devastating consequences. For instance, according to a report by the National Academy of Medicine, it is estimated that 5% of U.S. adults who seek outpatient care each year experience a diagnostic error. 

Postmortem examination research spanning over decades shows that diagnostic errors contribute to approximately 10% of patient deaths, and medical record reviews suggest that diagnostic errors account for 6% to 17% of adverse events in hospitals. 

Moreover, diagnostic errors are the leading type of paid medical malpractice claims and are almost twice as likely to have resulted in the patient’s death compared to other claims. 

According to Mayo Clinic, more than 20% of patients who sought a second opinion had initially been misdiagnosed by their primary care providers. Only 12% have their cases correctly diagnosed initially, the rest of the diagnoses all differed in some aspect. In 21% of patient cases, the second opinion indicated a “distinctly different” diagnosis from the first diagnosis, and in 67% of cases, the diagnoses were partly correct but “better defined/refined” by a second opinion.

Treatment choices that patient usually goes for are determined largely by local medical opinion concerning the value of surgery or its alternative. 

Health outcomes are threatened when doctors prescribe a treatment like a particular surgery for chronic back pain when there is no evidence proving positive long-term outcomes and when a less expensive treatment option, like physical therapy, is available. 

A medical second opinion can avoid many unnecessary surgeries that are claimed to have led to thousands of avoidable deaths. 

These unnecessary treatment options lead to the burden of billions on the government, which can be avoided by a medical second opinion.

With the impact of the COVID-19 pandemic, healthcare service providers are launching online platforms for patients to access second opinion services. This is expected to drive market growth over the forecast period. For instance,

In August 2020, Motic Digital Pathology launched its telepathology program, which allows pathologists to connect with labs and patients around the world. 

The cloud-based platform supports most slide formats on the market, allowing for multi-site management, international pathology, and other collaborative projects. 

As the consultant, a specialist can collaborate remotely with referring hospitals using the MoticFlow platform. They can leave annotations on specific parts of the slide, invite experts for a second opinion or forward the case to another consultant.

On August 19, 2020, Cleveland Clinic announced a new multi-faceted collaboration with Aetna, a CVS Health Company, to form an Accountable Care Organization (ACO) model and offer new plans and programs featuring Cleveland Clinic providers. The collaboration includes the launch of a co-branded insurance plan, which could reduce health care costs for participating employers, an expanded relationship nationwide to provide members enrolled in Aetna commercial plans access to second opinions by Cleveland Clinic for certain conditions, and the deployment of Cleveland Clinic’s Cardiac Center of Excellence (COE) program to Aetna plan sponsors.

In August 2020, the All India Institute of Medical Sciences (AIIMS) launched an online terminal to ease the burden over doctors’ shoulders working at the premier hospital along with the patients coming from far-off places. The institute has recently incorporated an online video consultation link on its website, through which a patient can directly take medical consultation, especially second opinions, and post-surgery pointers & care directions. 

In the early 1970s insurance companies started using second medical opinions (SMOs) as a utilization review technique (called second surgical opinion programs, or SSOPs) to reduce costs associated with overuse and inappropriate surgery. With this fundamental change, getting a second opinion was no longer a choice. Rather, patients facing elective or high-cost surgery were required to get one to verify that the procedure was clinically appropriate.

Patients and consumer groups have lobbied state legislators, claiming that second opinions are crucial for obtaining unbiased health information and that access to and coverage for them is being unjustly restricted. In response, health plans have stated that SMOs are provided when appropriate.

Florida, Indiana, Louisiana, Missouri, New Hampshire, and New York all have laws protecting patients’ access to SMOs and establishing when insurers or health plans can be held financially responsible. 

The health plan or insurer is accountable for most charges associated with the SMO. In Florida, the state with the most-specific legislation, patients may go to a physician who is unaffiliated with their health plan, and the plan is responsible for all usual, reasonable, and customary charges. Health plans in Florida are allowed to include coinsurance rates and co-payments for second opinions in the enrollee’s contract, but the enrollee’s responsibility is capped at 40%. While these laws help to clarify coverage for the first SMO, few states have included contingencies for conflicting second opinions or for covering third or fourth opinions. 

Second Medical Opinion (SMO) laws may be part of workers’ compensation regulations, state insurance codes, or both. New Hampshire and Louisiana passed laws that changed workers’ compensation, while Indiana and Missouri passed laws that only affected health maintenance organizations (HMOs) and health services corporations, respectively.

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Email: [email protected]
Tel: +1 877 441 4866

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