From Watchdog.Org, via US News & World Report:
Top Hospitals Opt Out of Obamacare
Americans who sign up for insurance on the state exchanges may not have access to the nation’s top hospitals, Watchdog.org reports.
(For the record, Watchdog.org is a non-profit news website that is a project of the Franklin Center for Government and Public Integrity.)
By October 30, 2013
… Most of the top hospitals [in the US] will [only] accept insurance from just one or two companies operating under Obamacare… [R]esponding to Obamacare caps on premiums, many insurers will, in turn, simply offer top-tier doctors and hospitals far less cash for services rendered.
Watchdog.org looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014. We contacted each hospital to determine their contracts and talked to several insurance companies, as well. The result of our investigation: Many top hospitals are simply opting out of Obamacare.
Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.
Meaning, if you don’t happen to have Medical Mutual of Ohio insurance, you are out of network. And if you go to the Cleveland Clinic will have to pay for all of your hospital costs out of your pocket.
And that’s not because their exchanges don’t offer options. Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states’ premier hospitals – Cleveland Clinic and Cedars-Sinai Medical Center – have only one company in their respective networks.
A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies. Other than that, the hospital with the largest number of insurance companies is University Hospitals Case Medical Center in Cleveland with just four. Fully 11 of the 18 hospitals had just one or two carriers…
Given that the exchange sites lists dozens of plans, your odds of picking a plan that will be accepted by your doctor or your favorite hospital are slim and none. And it gets worse:
Consumers, too, will struggle with the new system. Many exchanges don’t even list the insurance companies on their web sites. Some that do, like California, don’t provide names of doctors or hospitals.
Meaning that it’s practically impossible to find out what plans on the exchange are accepted by which hospitals and doctors. So signing up for a plan is a total crap shoot. With the emphasis on ‘crap.’
The price differences among hospitals "can be pretty profound," said Joe Mondy, spokesman for Cigna insurance. "When you are doing a cost comparison with doctors, you should look up the quality of the hospital as well. Hospital ‘Y’ could be great at pediatrics and not great at surgery."
Insurers operating in the exchanges are apparently hesitant to talk about the trade-off between price and quality. Two of the nation’s largest insurers – Wellpoint and Aetna – refused to respond to a dozen calls and emails placed over the course of a week.
They have probably been intimidated into silence by the government.
This article was posted by Steve Gilbert on Friday, November 1st, 2013. Comments are currently closed.