Health Care Thoughts: Really Narrow Networks

by Tom aka Rusty Rustbelt

Health Care Thoughts: Really Narrow Networks

“Narrow networks” are in the news as the ACA exchanges begin to do business (or not?).

From the Columbus Dispatch: http://www.dispatch.com/content/stories/local/2013/10/07/low-cost-premiums-thin-out-providers.html

There may be other problems besides low payment rates. According to the Medical Group Management Association (MGMA) contracting is slow, uncertainty is high, and physician groups have not been read in to the administrative practices of the exchange plans.

(Disclosure: I have done editorial work and seminars for MGMA.)

But wait, we have almost three months, right? Insurance contracting and administrative processes can be put into place, right?

Three months is not really long enough. Physician practices may be satisfied picking up new Medicaid patients, or just staying with the existing practice base, or playing wait-and-see.

The insurers should have had networks fully in place before October 1. Now we scramble. Again.

 

Tags: Comments (4) | |