Obamacare is causing Doctors
to choose patients. Or better said …. Doctor accept Obamacare patients, and go
broke. It is all falling apart!
So
Obama, and the Democrats pass into law a lie! What ever happened to “if you
like your Doctor you can keep your Doctor”? Well now we see Doctors cannot
afford to keep patients with Obamacare, so Bye..Bye! What about a family will
see a $2,500 savings? Another lie. The whole thing is falling apart, and
America’s physicians are left holding the bag, which is bad enough, but this
bag has a giant hole that negatively affects us all!
Highmark to cut doctors' payments for Obamacare plans
Pittsburgh Tribune
Friday, Feb. 19, 2016,
5:18 p.m.
Wes Venteicher
Citing
an estimated $500 million loss last year on health insurance plans sold on the
Affordable Care Act marketplace, Highmark Inc. said Friday it plans to reduce what it pays doctors who treat
patients with the plans.
Highmark plans to reduce payments
to the physicians by 4.5 percent starting April 1 as part of a broad effort to
stem losses related to the federal marketplace, said Alexis Miller, Highmark's
special vice president of individual and small group markets.
Miller estimated the insurer paid
about $500 million more for patients' care in 2015 than it collected in
premiums for the plans sold on the federal marketplace, resulting in the loss.
Highmark officials have said the people who signed up through the health
law's marketplace were sicker than the insurer expected.
John Krah, executive director of
the Allegheny County Medical Society, said doctors should not be held responsible
for Highmark setting plan costs too low to cover patients' care.
“It's inappropriate for Highmark
to seek to compensate for their failure to price these products appropriately
by paying physicians less,” Krah said.
Faced with lower reimbursement
rates for ACA patients, doctors could end up setting quotas for how many of the
patients they would accept at their practices, the way they do for Medicare and
Medicaid patients, he said.
“All policy has pushed practices
to run on a business basis today,” he said. “So they make the same kinds of
decisions a business makes. They can only have certain percentages of patients
with those types of insurances.”
Highmark's announcement comes as
insurers across the country report losses on the federal marketplace for last
year. UnitedHealthcare, the nation's largest insurer, has suggested it may
exit the market based on anticipated losses of close to $1 billion.
Miller said decreasing payments
to doctors would help Highmark continue to participate in the federal
marketplace, ultimately helping to keep the marketplace sustainable.
“Because we're committed to this
market, as long as we can make it sustainable or viable, we are systematically
working through all of the things that we can do to make that viable,” she
said.
The insurer raised premiums by an
average of 20 percent for its 2016 marketplace plans, changed its networks,
reduced commissions to brokers selling the plans and has taken steps to
aggressively manage the care of patients with the plans, Miller said.
The insurer made the change
Monday in an online system through which it interfaces with physicians, and
began sending letters to physicians Friday, Miller said.
In 2015, 280,000 Pennsylvanians
were enrolled in Highmark plans purchased through the federal marketplace.
Highmark has said it will announce the latest number in the coming weeks,
including signups during the open enrollment period that ended Jan. 31.
UPMC announced Thursday that it
had captured a much larger share of the 2016 market than it had in 2015.
Reimbursement for hospitals,
whose contracts with insurers work differently, would not change, Miller said.
The change affects all Pennsylvania physicians treating patients with
marketplace plans from Highmark, including physicians employed by Highmark-owned
Allegheny Health Network. UPMC physicians would not be affected since
payment arrangements between UPMC and Highmark are set in a state consent
decree, Miller said.
Highmark reported the rate change
to the Pennsylvania Insurance Department, but the proposed change doesn't
require the department's approval, said spokeswoman Ali Fogarty.
Highmark, like other insurers,
has not yet received reimbursements the federal government promised for losses
on the ACA plans. In June, Highmark expected to recoup $221 million through the
federal program.
Wes Venteicher is a
Tribune-Review staff writer. Reach him at 412-380-5676 or wventeicher@tribweb.com.
