MEDICARE HMOs: Left with Little Choice, Says Exec
Writing in yesterday's San Mateo County Times, Leeba Lessin, president of PacifiCare's Northern California operations, reassures concerned Medicare HMO enrollees that the company has "no plans to leave" the area. "Unfortunately," she writes, "as things stand today, HMOs have no choice but to leave areas where the cost of providing care to seniors outstrips government payment rates ... onerous new regulations that increase the cost of operating in these areas are an unintended consequence of the Balanced Budget Act of 1997." Thus, many Medicare HMOs are left between a rock and a hard place -- either providing "substandard care or suffer[ing] severe financial losses" -- and decide instead to "leave or be forced out of markets altogether." The answer to securing the Medicare HMOs, she writes "is to revise the government's payment methodology so that it doesn't penalize rural areas, and to eliminate the regulations of the Balanced Budget Act that increase the cost of health care rather than improve it." Lessin concludes that providing Medicare beneficiaries with a "consistent health care delivery system" can be achieved only through "a stabilized Medicare program, predictable payment rates that cover costs and reasonable rules for all Medicare plans" (3/15).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.