Sunday, November 8, 2015

Doctors, Hospitals Say 'No' to Obamacare Plans

Patients continue to learn that coverage is different from access.
Government health officials worked diligently this year to improve consumer experience on 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."
In an interview with reporters Oct. 30, Sylvia Burwell, secretary for the Department of Health and Human Services, said her agency did not have the authority to compel providers to accept the marketplace plans. The key, she said, was to create tools to engage consumers and to improve transparency so they can make educated decisions about health plans.
Read the full story HERE.

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