For U.S. health-care professionals, few terms are more encumbered than “managed care.” Carol McConnell, DVM, MBA, deals with the negative connotations every day, and she doesn’t even work on the human side of the care equation. “Probably the No. 1 concern I hear from veterinarians is that if pet insurance evolves as it has on the human side, insurers will start telling them what they can and can’t do,” says Dr. McConnell, chief veterinary medical officer for Veterinary Pet Insurance Co. of Brea, Calif. “That’s the whole world of managed care.” The reality of pet health insurance is actually a world apart, says McConnell, who is joined by others in the industry, including clinicians, seeking to educate veterinarians about the benefits of building an insured clientele. Unlike human health insurance, a pet health policy provides fee-for-service indemnity coverage, similar to a car, boat or homeowner policy. In fact, when insurers apply for a license with state departments of insurance, they sometimes get lumped in with marine policies “because they don’t know what else to do with us,” McConnell says. “We’re up there with the motor boats.” The upshot is that insured clients pay for veterinary care under the terms set by the clinic, just as uninsured clients do. The difference is that insured pet owners get to file a claim with their insurance company and are reimbursed according to the terms of their policy. On the human side, many health insurers have “incredible power,” including negotiating rates with medical groups, McConnell adds. “That’s not going to happen on the animal side,” she says. Reaching a similar conclusion is a research report published this year by the National Commission on Veterinary Economic Issues. The report, “A Veterinarian’s Guide to Pet Health Insurance,” says “Pet health insurance has neither the power nor the incentive to foist managed care onto the (veterinary) profession.” Sheldon Rubin, DVM, is director emeritus of Blum Animal Hospital, a 10-doctor, AAHA-accredited practice in Chicago. He says he has long been a proponent of pet health insurance for a number of reasons, foremost because he’s convinced it helps ensure that his patients get the highest-quality care he can provide. “If clients have the appropriate policy that covers routine blood work, dental, heartworm test, etc., then it really provides the incentive to get their pets proper preventive care,” he says. “Clients are much more likely to be compliant.” The effect of pet insurance tends to be even greater for clients whose pets are covered for emergency care and serious illnesses. Instead of facing an unaffordable bill—or a choice about their pet’s health they don’t want to make—the clients can opt for potentially life-saving treatments. “Pet owners with insurance quickly become our best clients,” says Christine Akers, insurance coordinator for the nine-doctor Bowman Animal Hospital and Cat Clinic in Raleigh, N.C., as quoted in the NCVEI report. “They bring in their pets more often, are less likely to second-guess the veterinarian’s recommendation and are more likely to implement whatever follow-up care is prescribed.” Dr. Rubin’s experience is similar. Just the other day, he says, his hospital amputated a front leg of a cat with osteosarcoma, and now the patient is undergoing chemotherapy. The client is looking at a bill of perhaps $3,000 to $5,000. “The patient is doing quite well,” he says. “If it hadn’t been for insurance, the client wouldn’t have been able to do this for her cat.” While industry experts put pet insurance penetration at about 1 to 2 percent of pet owners nationally, Rubin estimates that 5 to 6 percent of his hospital’s 40,000 active clients have some level of coverage. “There’s no question that education makes a difference,” he says. Each time a client gets a new puppy or kitten, Dr. Rubin’s hospital provides information that includes brochures on pet insurance. He offers his own recommendations as well as examples of how much a lifetime of care can cost. McConnell, of Veterinary Pet Insurance Co., also notes the importance of educating staff members because they are often the ones asked insurance questions by clients. Doug Kenney, DVM, author of the book “Your Guide to Understanding Pet Health Insurance,” counsels veterinarians and consumers to take time to research company and plan options. He recommends insuring pets when they’re young (to avoid limitations on pre-existing conditions) and knowing exactly what procedures are covered before making a recommendation or signing on the bottom line. With a little effort, the research and decision-making process can be empowering, notes Kenney, of Frayser Raleigh Animal Hospital in Memphis, Tenn. Veterinarians and clients can know they’re doing what’s best for the pets. “When you’ve done enough research to make sure you have the right policy to meet your needs and your budget,” he says, “everyone benefits.” <HOME> This article first appeared in the September 2009 issue of Veterinary Practice News
