Unfair Advantage? United Healthcare Boots Thousands of MDs From Its Part C Medicare Plans

http://www.medscape.com/viewarticle/813318?t=1&topol=1

It would appear that all healthcare networks are getting more restrictive

From the article:

Dr Edward Kosinski (Cardiology Physicians, Fairfield, CT), also an interventionalist, received a similar letter from UHC more than a week ago, along with the 16 other cardiovascular specialists in his practice. About 3000 of their patients are affected, including >500 of his own patients, “people that I’ve cared for for over 20 years. I’d say that represents 10% to 15% of my practice,” he said.

A spokesperson for the Yale Medical Group (New Haven, CT), with >1000 physicians who are Yale University School of Medicine faculty, told heartwire that UHC has dropped it from its Medicare Advantage plans.

“Our decisions are based on providing a network of physicians whom we can collaborate with to help enhance health plan quality, improve healthcare outcomes, and curb the growth in healthcare costs,” he wrote. “Factors include geography and ensuring ready access to care, the relative performance of providers on a range of industry quality metrics, and a provider’s ability to deliver high-quality care for the most members in the most cost-efficient manner.”

The company did tell Thompson that its “network realignment initiative” is a nationwide plan and that the cuts are deeper in some other states, including Florida, where 45% of physicians were dropped.

The cuts’ impact could be especially hard on patients in remote areas. In an October 22 letter published in the Providence Journal , the director of health services on Block Island, 13 miles off the coast of Rhode Island, reports that all of the tiny island’s physicians received one of UHC’s termination letters

Medicare Advantage is the third version of what started out as Medicare HMO.. which faded away after about 10 years to be replaced by Medicare C… which faded away after about 10 years… which was replaced by Medicare Advantage … Since UH is the company that provides AARP’s medicare supplement and Advantage program… could AARP be looking for another insurance company to pay it for its valuable endorsement ?  Could this be the first step toward the same fate of Medicare Advantage’s predecessors ?

Could this be just pushing public healthcare down the path of the least expensive is the best… As one of my hospital Pharmacist friends recently stated… “we have a shortage of primary physicians and a greater shortage of primary care physicians who know what they are doing ”

 

 

Filed under: General Problems