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What is your opinion of closed-network health insurance plans, which would cost less by limiting health care provider choice?
By PBN Staff
Health maintenance organizations have been around for decades. They offer less expensive health care options within a closed system of providers. But many consumers did not respond to them.
Massachusetts is seeing a new plan similar to an HMO being offered by Tufts Health Plan based on a provider network established by Steward Health Care, the for-profit chain that has purchased a number of hospitals in the Bay State.
Steward is also waiting for state approval of its purchase of Woonsocket’s Landmark Medical Center, and there is speculation – based on published reports – that it would like to establish a system of health care providers in Rhode Island that would be the basis for a similar limited-choice health care plan in the Ocean State.
What do you think of that?
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The choice that consumers need goes far beyond limiting providers through an HMO or similar entity. Rather, the choice that consumers need is HOW MUCH insurance coverage we may be required to buy under Obamacare - which did NOT adequately limit health care profits. As long as there are profits to be made (that is, beyond salaries, technology, and other expenses), health care costs will continue to rise.
I want health insurance that does not offer a prescription plan - but will likely be unable to find one. If this isn't a clear message that Big Pharma stood much to gain through Obamacare - what is? I also want a plan with a high deductible - will I be able to get one of those?
Additionally, the US does NOT have adequate safeguards in place, or adequate reporting requirements (along the lines of national registers) to ID problems with certain devices (e.g., knee and hip replacement parts that have now been banned in Europe, where they do have such registries) and to ENSURE that patients/consumers are receiving the best quality care at the best price.
Thursday, December 29, 2011|Report this
The goal here is for more coordinated care. I do not believe creating these closed organizations are going to provide us with the cost savings that we desire. Yes they will reduce expenses through better coordination of care but there is no guarantee that those savings will be shared. We need to have more transparency of prices and quality measures and tools in place for primary care and specialists to pass information between providers.
the system should be open with competing providers whose prices and quality measures are highly visible and available to all consumers. Then our medical information must be able to be transfered to our physicians and hospitals efficiently so that redundant tests and inefficient record keeping is eliminated. This will give us the advantages of a closed system (access to important patient info) without the potential for little monopolies who will force out those providers who dont join the big groups. Thursday, December 29, 2011|Report this