Physicians Unload about Health Insurance Problems
CANFIELD, Ohio -- Four physicians and the executive director of the Mahoning County Medical Society gave U.S. Rep. Bill Johnson, R-6 Ohio, an earful Tuesday about the shortcomings of health insurance since the Affordable Care Act was passed.
They met with the congressman in City Hall.
The doctors were especially upset that some of their long-time patients had been belatedly informed that they could no longer participate in UnitedHealthcare’s Advantage program and thus the carrier would not reimburse the physicians for care provided.
The physicians were Sean McGrath, president of the medical society and who practices physical and rehabilitative medicine in Poland and Columbiana; Larry Schmetterer of Salem who practices thoracic and vascular medicine; H.S. Wang of Eye Care Associates who has practiced 30 years; and Gregory Facemyer, who practices family medicine in Austintown. Karyn Frederick is executive director of the Mahoning County Medical Society.
Besides learning that UnitedHealthcare would no longer cover many of their patients’ bills -- some physicians were upset to learn of the carrier’s decision from their patients before UnitedHealthcare informed them -- the physicians expressed unhappiness at the state of the medical profession.
Wang observed that the doctor “in private practice is disappearing. Sixty percent of physicians work [directly] for a hospital.”
Facemyer complained about the “hidden fees charged a [medical] facility not reimbursed by insurance” and the requirement in the Affordable Care Act that physicians convert the paper files they maintain on their patients to electronic records.
That gave Johnson the opening to decry the lack of coordination among the makers of electronic medical records so that an authorized party, whether physician, nurse, or insurance carrier, can easily access a patient’s information.
Musing aloud, he proposed a presidential senior cabinet post for information technology with no administrative responsibilities and no bureaucracy to oversee. This individual would be capable of sorting out the various IT programs and ensuring that they can talk to one another. He followed up by remarking, “Just because something can be automated doesn’t mean it should. A steady pen on a piece of paper” should suffice to for a doctor to monitor his patients’ conditions.
But the physicians hoped that Johnson could intervene with UnitedHealthcare as he did in behalf of N.E.O. Urology Associates, a practice of five doctors with offices in Austintown, Boardman, and Warren. In a letter dated Jan. 17, they thanked him for “our reinstatement in the United Healthcare Medicare Advantage Network. This termination would have severely inconvenienced our 400-plus patients who would have had to leave our practice to find another urologist or change to another Medicare product. … We hope that citizens and physicians will [also] have someone who will listen and challenge unfair actions of large insurance companies.”
McGrath said he did not know why UnitedHealthcare dropped so many physicians in the Valley. He did know that the carrier should have notified the affected patients by Oct. 1 so they could buy insurance through an exchange or sign with another carrier during open enrollment.
Since open enrollment has closed, they’re left having to see another United Healthcare physician, McGrath said, which might entail traveling to Cleveland or Pittsburgh. The Medicare Advantage, he said, is a blessing, a huge cost savings, to those who are enrolled in Medicare.
UnitedHealthcare, McGrath said, did not drop physicians “in a thoughtful way. There was no transparency. The physicians were just cut.”
In a statement, UnitedHealthcare said the changes it made "are designed to bring better health outcomes and more-affordable health care coverage to our Medicare Advantage members."
Johnson repeated his arguments against Obamacare although he conceded some aspects have merit. Not enough, however, that he would keep the program were it up to him.
He’s remains opposed to the government at any level being involved in providing or paying for health care. He sees such care a something that should, in its entirety, be left to a physician and patient -- payments, recordkeeping, prescribing drugs.
The physicians also complained about the added paperwork and record-"keeping that has become a part of their practices, whether its records the insurance carriers demand or to comply with Obamacare.
Johnson sympathized, saying, Physicians should not spend their lunch hour entering data.”
Copyright 2014 The Business Journal, Youngstown, Ohio.
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