San Diego Physicians’ Groups Ending Contracts with Medicare HMOs
Citing low reimbursement rates and "skyrocketing health costs," two San Diego County medical groups have severed ties with two Medicare+Choice organizations to avoid "the full risks" of costs, the San Diego Union-Tribune reports. San Diego Physicians Medical Group ended its contracts with Blue Cross and Secure Horizons, while Mercy Physicians Medical Group has reached a contract "impasse" with Secure Horizons. As a result, patients must either switch to a Medicare+Choice plan that their doctor accepts, find a doctor who accepts their plan or return to traditional fee-for-service Medicare coverage. The Union-Tribune reports that switching health plans may result in higher monthly premiums and co-payments or a reduction in prescription drug coverage. In addition, patients opting to stay with their current plan may have to travel farther to see a doctor. However, many patients would not consider switching doctors (Fong, San Diego Union-Tribune, 2/14).
Seniors in Orange County face a similar choice, as hospitals, health plans and physician groups "wrestle with Medicare reimbursement" that they argue has "plunged below" increasing medical costs. Meanwhile, the senior population in Orange County will likely double in the next 20 years, creating an even larger demand for Medicare funded health care (Haas/Metivier, Orange County Register, 2/14).