ORANGE COUNTY: Doctors Scale Back HMO Contracts
Citing low reimbursement rates and quality of care issues, some Orange County medical groups are shedding their HMO contracts. The Orange Country Register reports that Memorial Prompt Care in Westminster recently dropped all its HMO plans, a move which puts the eight-doctor group at risk of losing 1,000 patients. However, "the group is gambling that patients are also fed up with HMOs and will switch to more expensive health plans to keep their doctors." Memorial's scale-back coincides with open enrollment season, and the doctors predict that patients frustrated with mandated referrals and brief appointment visits will follow the doctors' lead. On the heels of Memorial's move, Irvine Family Practice this month dropped out of an independent physician association that serves 2,500 HMO members. The Register reports that the group stands to lose up to 20% of its practice. Dr. David Paskil, former member of the IPA, said "We fully expect that they [patients] will return. It is a risk we are willing to take."
Against The Tide
The Register notes that while Memorial's "stance smacks of revolt," some health care experts say "it is too early to declare a revolution." California Medical Association spokesperson Elizabeth McNeil said, "You hear about this happening in little pockets all over the state. There have been feelings of revolt for a long time, but whether most doctors can act on it is another thing," given that 20 million Californians are enrolled in HMOs. Other doctors, however, have taken significant action, the Register reports. Dr. Thomas LaGrelius founded the Independent Doctors Traditional Practice Association, "a group of individual doctors who have sworn to rid themselves of all HMO contracts by 2000." LaGrelius said, "Patients are disgusted with HMOs, and they are a fertile field for doctors who raise their hand and say, 'I will not participate in this'" (Au, 12/15). Click here for recent CHL coverage of Orange County physicians feeling squeezed by managed care.