MEDICARE HMOs: Trigon, United, AZ Blues Join Exodus
Reports of Medicare HMO pullbacks and closings continue to trickle in from across the U.S. Citing $3.4 million in pre-tax losses last year, Richmond, VA-based Trigon Healthcare Inc. will end its HealthKeepers Gold plan Dec. 31, forcing 2,700 seniors to re-enroll with another Medicare HMO -- Cigna Corp. is the only remaining option in the Richmond area -- or return to the combination of fee-for-service Medicare and a Medigap plan. Trigon President and CEO Thomas Snead said, "We are disappointed to have to make this decision. Unfortunately, concerns about reduced funding for Medicare+Choice plans have left us no other choice" (Ress, Richmond Times-Dispatch, 7/3).
United Healthcare Corp. will end its 18,000-member Medicare Complete plan in Louisiana, and the state's largest Medicare+Choice provider, Ochsner Health Plan, is pulling out of 28 parishes containing 16,800 enrollees, the Baton Rouge Advocate reports (Shinkle, 7/3).
In Arizona, Blue Cross and Blue Shield of Arizona has discontinued its 13,000-member Medicare Blue plan, and Humana Inc. and United HealthCare of Arizona announced pullouts from several counties (Erikson, Arizona Daily Star, 7/5).
In television coverage this weekend, managed care officials and consumer advocates traded blows on NBC's "Nightly News." Families USA Foundation President Ron Pollack said, "[They] bait you to try to join the plan and then they switch the benefits, the cost, or they even drop out of the program." American Association of Health Plans' Susan Pisano countered, "We've always said, we can do better than the traditional program for less. We've never said we could work miracles" (7/2). On NBC's "Meet the Press," HHS Secretary Donna Shalala attempted to harness outrage over Medicare HMO pullouts to power Clinton's prescription drug coverage proposal (see story 1), saying, "Well, we can't stop it, because these are private-sector companies. What they will continue to do is to provide the Medicare benefit. What they've been doing is adding more benefits. They're going to trim back on some of those benefits, which have enticed people into managed care. The difficulty they have is, it's going to slow down the number of Medicare beneficiaries who want to go into managed care. They're scaring them by changing the benefit package. That's why we need to introduce the drug benefit, to make sure that Medicare beneficiaries get whatever health care plan they go into" (7/4).