Doctors, Hospitals Say 'No' to Obamacare Plans

[PoliticAverse]

Government health officials worked diligently this year to improve consumer experience on Healthcare.gov and make sure people know what they are getting for their money when they pick health insurance. But one thing is out of the government's control: whether doctors and hospitals will agree to accept patients who buy these plans.

Surveys and data are limited, so it's difficult to gauge the extent of the issue, but anecdotal evidence from patients and providers show it is a struggle. Some newly insured patients wonder whether it's worth paying for coverage they can't actually use. Even when they do find a provider, reports show they face crippling out-of-pocket costs they didn't expect.

Doctors or hospitals may be left out of insurance networks for many reasons; the decision is usually up to the insurance company, not the provider, but it usually comes down to reimbursement, which can be lower through plans obtained via the Obamacare marketplace.

"We have no idea what the plans are paying," says David Howard, professor in the department of health policy and management at Emory University. "That's closely guarded information. We can only draw conclusions based on anecdotal reports."

Read the rest at: http://www.usnews.com/news/articles/2015/11/04/doctors-hospitals-wont-accept-obamacare-marketplace-plans

[malaise]

1. The vast majorities of doctors are corporate

employees

[LiberalArkie]

3. Very few can afford their own practice any more.

[Fumesucker]

4. Yes, I ran into that just recently...

Old family doctor but now is part of big medical corporate practice, personally perfectly willing to take my Medicare but corporate says no.. So I'm still looking for a doctor.

[ALBliberal]

2. Anecdotal Evidnce.....not buying it.

[WinkyDink]

7. Nor am I.

[mercuryblues]

5. So hospitals

prefer to get $0.00 reimbursement, instead of what the ACA will pay. They want to go back to the good old days of bad debt and bill collectors.

[PoliticAverse]

18. One of the problems with the ACA (as the article mentions) is that there is a 90 day window...

where the plan purchaser can not pay for a plan leaving the provider on the hook
for the resulting 'bad debt'.

[dembotoz]

6. group health plan now hmo...just lost my doctor of 20 years

angry??? yes


due to obamacare???? not at all

[spinbaby]

8. When insurance companies own health systems

Here in PA, we have two competing health systems--UPMC and Highmark--who don't want to accept each other's insurance.

[taught_me_patience]

9. Here in Cali, Blue Cross ACA plans are reimbursing 20% less

No wonder doctors are not taking it. My wife is a GP and she's about to notify her patients that she'll be dropping the ACA plans. People do not do the same amount of work for 20% less revenue, which translates to 50% less income.

[OneGrassRoot]

10. While Blue Cross in California executive salaries have soared...

http://www.latimes.com/business/la-fi-blue-shield-pay-20150901-story.html

Nonprofit insurer Blue Shield of California boosted executive compensation by $24 million in 2012 — a 64% jump over the previous year — according to a confidential state audit reviewed by The Times.

The state requires companies like Blue Shield to submit information on annual pay, but the company interprets the rule to apply only to executives still employed at the time it files the paperwork — in this case, March 2013. Bodaken and other executives had left by then.

The revelations about the compensation — and the company's assertion that it doesn't have to disclose Bodaken's full pay — come at a time when state officials are already scrutinizing the company's nonprofit status.

"What is Blue Shield trying to hide? This raises so many red flags," said Frank Glassner, chief executive of Veritas Executive Compensation Consultants in San Francisco. "Blue Shield owes policyholders an explanation for how it spent this money."

[bananas]

14. "What is Blue Shield trying to hide? This raises so many red flags," nt

[B Calm]

17. They are hiding their profit margins by increasing CEO salary. ACA mandates that insurance

companies can only make 20% profit!

[Person 2713]

12. + 1

[Person 2713]

13. + 1

[underahedgerow]

11. The gravy train is coming to an end. The days of yachts and lion safaris are soon

to be over for US medical professionals, and that's a good thing. A doctor should be in the medical profession to provide medical care, not to get rich.

The average doctor in France makes about 60K a year. A decent, ordinary living wage. But their education was paid for by the state, not by massive student loans. So that doctor doesn't need to make a million bucks a year to pay off their loans.

And, they still make house calls. Go figure.

[taught_me_patience]

20. Nobody is going to take that job

Causing a major shortage of doctors. GP's make an average of 200k, and there is already a shortage of them.

[PasadenaTrudy]

15. It happened to

my boyfriend here in CA. I also had a doctor not accept my non-ACA Blue Shield plan. I've switched to Kaiser now so I don't have to deal with this bullshit. All services in one place makes it easier.

[B Calm]

16. Are they saying no to all the ACA plans or just select ones?

[PoliticAverse]

19. Different providers/plans will have different reimbursement rates.

Although it appears some doctors/hospitals are rejecting all ACA plans others
are just rejecting those that are reimbursing significantly less than the plans
they are currently accepting.