User Login    
 + Register
PDQ Cleaning
News : Thousands In Missouri May Need New Doctors
Posted by Randy on 2014/6/20 4:42:22 (537 reads) News by the same author

ST. LOUIS (AP) - UnitedHealthcare has notified more physicians in Missouri that they will be removed from the company’s Medicare Advantage plan on Sept. 1.
Click to see original Image in a new window

This is the second round of cuts to UnitedHealthcare’s Medicare Advantage physician ranks, following reductions in April. The provider is the largest carrier of Medicare Advantage plans for seniors in the nation, with about 95,000 plan members in Missouri.

Dr. Joseph Craft III, a cardiologist and president of the St. Louis Metropolitan Medical Society, said his organization was hearing every day from doctors who have received a termination notice.

While the society is not aware yet how many of its members have been terminated, “we know ultimately this is going to affect thousands of patients in the St. Louis area,” Craft said.

UnitedHealthcare terminated almost 100 Missouri physicians from its Medicare Advantage plan in April, which prompted a scathing letter from the Missouri State Medical Association. The provider said then that eventually 5 percent to 7 percent of the more than 10,000 physicians in the state would be eliminated this year.

In an email Wednesday, UnitedHealthcare said the cuts affected less than 10 percent of the state’s physicians, which would translate to fewer than 1,000 physicians. While the company manages its network on an ongoing basis, UnitedHealthcare does not expect to make any more changes to its size in Missouri this year.

While Craft said he thinks physicians of all specialties have been affected, this month’s cut seems to target dermatologists, ophthalmologists, gastroenterologists and orthopedic surgeons.

Dr. George Hruza, a Chesterfield dermatologist and president-elect of the American Society for Dermatologic Surgery, received the network termination on June 2. After contacting St. Louis area dermatologists, he learned at least 36 had also been terminated. That amounts to almost half of the skin specialists in the area.

In St. Charles County, for example, he said three dermatologists had been cut from the network. Those three are the only specialists in the county who perform Mohs surgery, which has a 99 percent cure rate for the most common type of skin cancer.

“This area has a lot of farmers, so a lot of people who have sun damage — these patients are now asked to find another doctor,” Hruza said.

Most of the dermatologists who stayed in network, he said, are in the center of St. Louis, and many belong to a larger health care group, such as a university.

This is a problem because universities already have about a three-month waiting list for patients, Hruza said.

“They’re gonna put thousands and thousands of patients into such a small group of physicians.”

Craft said he thought UnitedHealthcare might be trying to push patients into service delays or toward doctors affiliated with bigger medical groups. He doesn’t see how that would save money for the provider, though.

“But again we’re only speculating ... because they haven’t offered anyone an explanation,” he said.

In the physician notices, UnitedHealthcare cites a no-cause termination. Hruza says the insurer’s contract states it is not required to give a reason for termination.

This makes it harder for physicians to appeal the termination because they don’t know what aspect of their practices they need to defend.

UnitedHealthcare said in an email Wednesday that the main factors for the change were the health industry’s move toward quality over quantity and a closer collaboration between insurers and doctors. With a smaller group of doctors, patient data could be shared better as well.

Missouri is not alone in the cuts. Last year, UnitedHealthcare began making terminations in several states. By the end of the year, the company expects to be 10 percent to 15 percent smaller than it was at the beginning of 2013.

These changes are being made in the middle of the policy year, so patients cannot switch to plans that include their doctor.

“The relationships (doctors) have with their patients is being disrupted arbitrarily, mid-contract term, with no explanation,” Craft said. “It’s not reasonable. It’s not fair to patients to do that.”

Jessica Kostner, spokeswoman for UnitedHealthcare, said these changes could be unsettling.

“We are working to make transitions to new doctors as smooth as possible and will do all that we can to prevent interruptions in care,” she said.

Printer Friendly Page Send this Story to a Friend Create a PDF from the article


Other articles
2014/7/25 6:26:53 - Motorcycle Accident Injures Cameron Resident Near Mooresville
2014/7/25 4:42:55 - Child Abuse Charges Include Snakes, Lizards And Alligators
2014/7/25 4:40:00 - Search Warrant Leads To Two Meth Suspects
2014/7/25 4:30:00 - 3 Convicted In $17 Million Drug Conspiracy
2014/7/25 4:26:15 - Woman Ticketed After Stopping To Help Stranded Ducklings
2014/7/25 4:22:33 - 10-Month-Old Baby Dead After Being Left In Hot Car
2014/7/25 4:15:23 - Husband Documents Wife's Reasons For Rejecting Sex, Sends To Her Work Email
2014/7/25 4:07:44 - Family Feud Sparks Revolt At Grocery Store Chain
2014/7/25 4:01:28 - Livingston County Sheriff Investigation Report
2014/7/24 11:03:48 - Two Spickard Residents Arrested On Drug Charges
2014/7/24 10:51:09 - Fire Damages Trenton Residence This Morning
2014/7/24 10:50:00 - Inmate At Daviess/DeKalb Jail Charged With Hitting Man 240 Times
2014/7/24 10:10:45 - Highway 65 And 28th Street Topic Of Meeting
2014/7/24 9:59:51 - Two Have Cases Heard In Court At Trenton
2014/7/24 9:56:09 - Caller Posing As Grundy Electric Employee In Attempt To Collect Payment
2014/7/24 9:52:51 - Trenton Resident Arrested
2014/7/24 4:46:07 - Man Caught Snapping Pictures At Pool With Concealed Camera
2014/7/24 4:35:31 - KC Leaders Endorse Ban On Openly Carrying Guns
2014/7/24 4:28:51 - Couple Arrested For Having Sex On Public Beach In Broad Daylight
2014/7/24 4:26:02 - 4-Year-Old Boy Banned From Doughnut Shop
2014/7/24 4:21:38 - Missouri Man Accused Of Leaving Infant Twins Unattended In Car
2014/7/24 4:14:50 - Arizona Execution Takes Nearly Two Hours
2014/7/24 4:09:06 - Missouri Couple Indicted On 9 Counts Of Illegal Synthetic Drugs
2014/7/23 9:17:41 - North 65 Center in Trenton To Hold Fundraiser
2014/7/23 9:11:50 - Dr. G Discusses "End Of Life"
2014/7/23 7:29:21 - Livingston County Sheriff Reports On Transports To Department Of Corrections
2014/7/23 6:39:12 - Highway Patrol: Prescription Drugs Responsible For Deaths And Emergencies Every Day
2014/7/23 6:33:00 - Spickard Board Of Education Meets
2014/7/23 6:28:38 - St. Joseph Woman Sentenced To 5 Year Prison Term For Fraud
2014/7/23 4:51:03 - Unique Church Service Caters To Deaf Community



Bookmark this article at these sites

                   

Listen to KTTN-FM