MEDICARE HMOs: Brown & Toland Applies For Federal License
Unlike other plans in the state that are backing out of the Medicare HMO market, Brown & Toland wants to enter it. The San Francisco-based independent physician association last month submitted a Medicare+Choice application to the federal Health Care Financing Administration, Managed Medicare & Medicaid reports. Kelly Robison, director of contracting for Brown & Toland, said her company believes "the wider HMO avenue" will give it "more options down the road." The IPA would like to get involved in POS offerings and Medicare fee-for-service business, and believes its new Medicare venture would give it a balance of commercial and Medicare members, according to Robison. Currently, Medicare managed care "penetration" in San Francisco is 35%, while Brown & Toland contracts with six Medicare HMOs throughout the state. Managed Medicare & Medicaid reports that Brown & Toland "contracts with 14 health plan for 190,000 members, of which nearly 17,000 are Medicare beneficiaries." The company changed its "limited Knox-Keene license for a full Medicare-only license" because it doesn't want to compete for commercial members with its HMO contractors, Robinson says (8/3 issue).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.