Abysmal payments. Lack of information. Even questionable business practices.
Those are all complaints physicians have had in the early stages of working with health insurance companies selling plans through the Affordable Care Act’s (ACA) health insurance marketplaces, also known as exchanges.
MedPage Today asked several attendees at this week’s American Medical Association’s interim meeting about their experiences with the new plan offerings. Responses from those with experience dealing with them on the whole weren’t positive.
“Neither the patients nor the physicians know if they’re in network or not,”said Steven Larson, MD, of Riverside, Calif., chairman of the California Medical Association’s Board of Trustees.
It has been a common complaint thus far, as plans have been slow to report or update provider networks for exchange plans.
Michael Sexton, MD, of Novato, Calif., said some physicians have received a letter stating they are in network for a plan unless they say otherwise. “One doctor told me he saw a document from a plan — with his [own] signature on it — that he never saw before.”
Richard DePersio, MD, from Powell, Tenn., said that one health insurer had contacted his practice about working with him, and he hadn’t heard of the plan before. Even worse, they offered rates lower than what Medicaid pays.
“I think everybody has an uncomfortable feeling about what is happening,” DePersio said.