Kevin Knauss: Health, History, Travel, Insurance
Posts related to doctors and health insurance plans, in-network, and their support of health care reform.
All new ACA health plans include acupuncture as a covered health care service in California. So what is it like to receive acupuncture and can it potentially help relieve medical challenges that some of us face? I decided to try out this traditional Chinese medicine to see if it would alleviate the pain in my neck.
California doctors, upon finding that the new Covered California health plans may not reimburse them enough to maintain their vaunted lifestyle, are kicking existing patients with the new health insurance out of their practices. These doctors are the epitome of the maxim “Putting profits before people.” Most of these greedy doctors haven’t exercised the common decency to notify their current patients before their appointments that unless they have the right color of health insurance, they won’t be served.
As the ACA open enrollment winds down, attention now turns to helping individuals and families in the new health plans actually get health care from their insurance. While there have been significant challenges just getting people signed up for health insurance, there will surely be additional hurdles as households now try to use the new health plans. For most people, they have no advocate to help them maneuver through the maze set up by health care professionals and insurance plans. Who will be the health insurance advocates for these families?
Consumers are growing frustrated as they find their current doctors aren’t included in new Covered California individual and family plan (IFP) health insurance networks. There is also widespread uncertainty about the rules of in-network providers with the new Exclusive Provider Organizations (EPOs) and California’s new 19 pricing regions. When California consumers are craving information the doctors have been silent and the insurance companies along with Covered California are providing scant information.
Covered California has already awarded $43 million for public outreach and education. Seven of the recipients that received grant money are organizations that are already involved with the health care industry. Yet we need more money spent just to talk to doctors, nurses and physical therapists?
Part of Covered California’s mission is to improve health care quality and lower costs. In an attempt to meet these goals they announced a partnership with the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely initiative. The Choosing Wisely initiative seeks to encourage better dialog between patients and physicians to reduce duplicative tests based on evidence when charting the most effective course of treatment.
The larger point of Anthem’s discussion is that rising health care costs have several roots. There is no one culprit that is driving costs.
The obstacle in matching your health insurance to a doctor is that health insurance companies contract with physician groups and hospitals. These contracts include negotiated prices for a variety of procedures, tests and office visits.
