PacifiCare, Health Net To Reduce Medicare+Choice Coverage in Northern California
Two HMOs announced this week that they will reduce their coverage under the Medicare+Choice program in Northern California, the San Francisco Chronicle reports. PacifiCare, which has already left parts of Contra Costa and Alameda counties, said it will leave the counties completely by Jan. 1, 2003, a move that will affect more than 10,000 seniors. The insurer also will cut 12,000 members in Butte and San Joaquin counties. In addition, Health Net said it would cease coverage in the Livermore area of Alameda County, affecting 460 beneficiaries. The Chronicle reports that Kaiser Permanente and Blue Cross also may be considering reducing their coverage area and that Blue Shield does not plan to leave any areas (Wallack, San Francisco Chronicle, 9/10). The announcements follow the release of an American Association of Health Plans survey on Monday that found that HMOs nationwide serving about 200,000 seniors will exit Medicare+Choice next year in large part because of inadequate reimbursement rates from the federal government (California Healthline, 9/10). AAHP President Karen Ignagni said that HMOs are being "forced out" of Medicare+Choice because federal reimbursement rates will increase 2% in 2003, while health care costs are expected to increase 12% (Goldeen, Stockton Record, 9/11). PacifiCare spokesperson Tyler Mason said, "It's definitely because of the reimbursement rates. Every year we have to look at the reimbursements we get from [the] federal government and see if we can put together a package that is affordable to the members and is a value." Mason added that PacifiCare will continue to offer the plan in Stanislaus County, but that "could change" if Congress does not increase funding for the program, the Modesto Bee reports (Carlson, Modesto Bee, 9/11).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.