LA Times: Insurers limiting doctors, hospitals in health insurance market

Benjamin Norman for The New York Times Patients at the Peekskill center, which may or may not get to keep a $4.5 million federal grant.

 

Cedars-Sinai Medical CenterMajor insurers have limited the number of doctors and hospitals available in California’s new health insurance market. Cedars-Sinai Medical Center, for example, is available only on two lower-priced Health Net plans in the state-run market. (Kirk McKoy / Los Angeles Times)
By Chad Terhune 

The doctor can’t see you now.

Consumers may hear that a lot more often after getting health insurance under President Obama‘s Affordable Care Act.

To hold down premiums, major insurers in California have sharply limited the number of doctors and hospitals available to patients in the state’s new health insurance market opening Oct. 1.

New data reveal the extent of those cuts in California, a crucial test bed for the federal healthcare law.

QUIZ: How much do you know about health care?

These diminished medical networks are fueling growing concerns that many patients will still struggle to get care despite the nation’s biggest healthcare expansion in half a century.

Consumers could see long wait times, a scarcity of specialists and loss of a longtime doctor.

“These narrow networks won’t work because they cut off access for patients,” said Dr. Richard Baker, executive director of the Urban Health Institute at Charles Drew University of Medicine and Science in Los Angeles. “We don’t want this to become a roadblock.”

To see the challenges awaiting some consumers, consider Woodland Hills-based insurer Health Net Inc.

Across Southern California the company has the lowest rates, with monthly premiums as much as $100 cheaper than the closest competitor in some cases. That will make it a popular choice among some of the 1.4 million Californians expected to purchase coverage in the state exchange next year.

But Health Net also has the fewest doctors, less than half what some other companies are offering in Southern California, according to a Times analysis of insurance data.

GRAPHIC: Prices in California’s health exchange

In Los Angeles County, for instance, Health Net customers in the state exchange would be limited to 2,316 primary-care doctors and specialists. That’s less than a third of the doctors Health Net offers to workers on employer plans. In San Diego, there are only 204 primary-care doctors to serve Health Net patients.

Continue Reading here: http://www.latimes.com/business/la-fi-insure-doctor-networks-20130915,0,2814725.story

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