Looks like it is okay for HMOs to come between you and your doctor. So long as the cost reductions go to the right people.
Employers are looking to purchase Health Plans from what is called "narrow network" HMOs because they "narrow" Health Plan Premiums. "Narrow network" HMOs also narrow down the short list of available doctors.
Employees who are provided such Plans through their Employers, as their alternative to no Health Insurance Coverage at all, are finding that they have to drop their doctors because so few doctors sign up for these HMOs.
Health Insurance Companies are reportedly promoting "narrow network" HMOs to Employers on the basis of paying out lower Premiums. The Health Insurance Companies apparently do not mention the lack of medical providers. See Duke Helfand, "A Shift Toward Smaller Health Insurance Networks/Thousands of Employers in California and Nationwide are Opting for 'Narrow Network' HMOs, Which Offer Notable Savings on Insurance Premiums But Also Offer Fewer Medical Providers" (Los Angeles Times Online, Sunday, April 3, 2011).
Where do you suppose that money that comes from this cost reduction, actually ends up? Wherever that is, is that the best business use of it?
Good questions. Someone should ask them. Oh, wait. I just did.
The author is Co-Chair of the Health, Life and Disability Insurance Law Subcommittee of the American Bar Association Insurance Coverage Litigation Committee.
Please Read The Disclaimer.
Comments