Blue Shield of California to Drop Medicare+Choice Plan in Several Counties
Blue Shield of California this week announced plans to drop its Medicare+Choice plan, 65 Plus, in five counties -- Kern, San Diego, Stanislaus, San Joaquin and Ventura -- and Riverside County's Coachella Valley and Los Angeles County's Antelope Valley next year, the Riverside Press-Enterprise reports (Beeman, Riverside Press-Enterprise, 10/4). Blue Shield officials blamed "skimpy" reimbursement rates for the decision. "This was a difficult and painful decision for us," Blue Shield Senior Vice President Lisa Rubino said, adding, "With health care costs rising much faster than the federal reimbursement rate, we simply could not afford the significant financial losses required to remain in these areas." Blue Shield's withdrawal, effective Jan. 1, will affect about 11,000 Medicare beneficiaries (McCray, Modesto Bee, 10/4).
Medicare+Choice, the "hottest thing next to sliced bread" when Congress established the program in 1997, has become "moldy with age," a Santa Rosa Press-Democrat editorial says. The editorial states that the HMOs and Medicare "are nearly impossible to mesh." The editorial points out that seniors have "more frequent and expensive" health problems than younger patients and use more prescription drugs, presenting a "challenge" for HMOs "structured to run on an administrative shoestring." In addition, the editorial states that "[e]xcessive paperwork and illogical regulations" in Medicare create additional problems for HMOs. The editorial concludes, "Unfortunately, a declining economy and increased defense spending have eliminated the possibility that Congress will address this problem (which was a high priority only last month) anytime soon" (Santa Rosa Press-Democrat, 10/4).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.