New HPR Plan Offers Direct Specialist and Hospital Access
Health Plan of the Redwoods is offering local companies "a new group health plan" giving members "direct access" to specialists and hospitals, the Santa Rosa Press Democrat reports. Development of the new "Access" plan was prompted "by complaints from doctors and patients about having to navigate the referral process through their primary physician." The plan will cost businesses 7% to 14% more than HPR's traditional primary care referral plan, and will charge a $30 specialist co-pay. The traditional co-pay is $10. While patients will still need to select physicians from a list of 400 participating doctors, the plan "abandons one of the main tenets of managed care adopted by HMOs" -- making patients route their medical care through a primary care provider. Unlike traditional HMOs, where members' access is limited to certain hospitals, participants in this new plan will be able to choose any hospital in Sonoma, Marin and Mendocino counties. Health consultant Bob Shirrell said that physicians and patients will appreciate the Access plan, but "the price may be an impediment at a time when companies are already cringing at paying increased premiums" that average 15%. However, HPR officials say that the plan's monthly premiums are "close" to the California Medical Association's estimated state average. Seven local companies have signed up for the Access plan since its Nov. 1 introduction (Rose, Santa Rosa Press Democrat, 11/21).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.