‘ALL OR NOTHING’ CONTRACTS: Doctors Fight Back
The growing consolidation of the health care industry is fueling a rise in "all or nothing" contracts that force doctors to accept all of a health insurer's plans, regardless of reimbursement levels, if they want to participate in any of them, the New York Times reports. Industry officials contend that the contracts provide continuity of care by allowing patients who switch plans to keep their doctors. However, Dr. Howard Weiner of the Genesis Physicians Practice Association in Dallas said, "The policy in essence drives a market to all-HMO care." Physicians in the Dallas-Fort Worth area have been embroiled in a bitter debate with Aetna U.S. Healthcare over "all or nothing" contracts. The Times reports that as of last week, 400 doctors in Tarrant County, TX, "were still holding out" against signing contracts with Aetna, which controls 39% of the local managed care market. The move came after 18 months of acrimonious negotiations fell apart when Aetna insisted on all or nothing contracts and the doctors refused. Furthermore, doctors nationwide are expressing concern that the insurer's looming $1 billion merger with Prudential Health Care would create a managed care behemoth capable of forcing "doctors to accept arrangements they contend would harm patient care" (Freudenheim, 2/8).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.