MAXICARE: Health Plan Threaten to Drop Medicare HMO Members
Joining the growing list of health plans that are pulling out of the Medicare HMO market, Los Angeles-based Maxicare Health Plans yesterday announced that it will stop offering its Medicare HMO product to thousands of seniors in California and Indiana, the Wall Street Journal reports. The withdrawal will affect about 6,100 seniors in Indiana and 3,000 seniors in California's San Bernardino and Riverside counties (7/12). Maxicare will continue to serve 9,000 Medicare beneficiaries in Los Angeles and Orange counties. Similar to other health plans, Maxicare officials blamed low reimbursement rates from the federal government for the pullout. Maxicare Executive Vice President Susan Blais said, "We looked at the needs of our members in those areas to see whether we could ensure that our members received the quality of care that they deserved, and we determined that they could not, based on the reimbursements in those areas." The decision is part of Maxicare's plan to restructure the company, which has suffered significant financial and image problems in the past (Bernstein, Los Angeles Times, 7/12). In June, a survey asking doctor groups to rate California's health plans gave Maxicare the worst rating according to how well the company interacted with and reimbursed physicians (Bernstein, Los Angeles Times, 7/8). Maxicare will drop its Medicare HMO members Jan. 1 (Los Angeles Times, 7/12).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.