BLUE SHIELD: Will Stop Signing Up Medicare HMO Members In Northern California
While not pulling out of the Medicare HMO market altogether, Blue Shield of California has said it would stop signing up seniors in Northern California. The Contra Costa Times calls Blue Shield's decision to halt marketing of its Shield 65 health plan "the latest example that Medicare HMOs are losing favor with insurers." Blue Shield said it would still provide care to the 6,000 Shield 65 members in Northern California, but it will "not actively try to solicit new members." Thomas Gwyn, Blue Shield's vice president of public affairs, said, "This will not affect existing members. We're still committed to the Medicare market." However, Blue Shield said the reimbursement rates in rural Northern California are often much lower than the actual costs of caring for patients there. "It's not been working for us in Northern California," said Gwyn.
Follow The Money
The Times reports that Medicare payments are "generally higher" in Southern California than northern or rural parts of the state. The reimbursement for a Los Angeles member is $635 per month, but is only $394 for a member in San Luis Obispo County. The Times reports that Blue Shield is ending enrollment in six counties -- Alameda, Contra Costa, San Francisco, Santa Clara, San Mateo and Sacramento -- which have reimbursements rates ranging from $490 to $583 per month (Appleby, 8/5). Click Health Net to read about Blue Shield's rival health plan dropping its Medicare HMOs in nine northern counties. Or click here to read California Healthline's coverage of the national trend of withdrawing Medicare HMOs.