Will Physicians Be Dropped From Managed Care Networks?

Greg Freeman , January 22, 2014

With all the emphasis on quality, some of the physician terminations may be surprising because the insurers are not just dropping poor performers, Osowski notes. At the same time they are looking for quality, they are looking for cost savings, and sometimes those goals can compete. The result sometimes is that the networks will drop physicians or groups that are providing high-quality care because that care skews too heavily in the expense consideration, he explains.

In addition, the insurance industry and consumers are not as focused on broad networks as they have been in the past.

"Now there is a feeling on the part of the plans that the appeal of the broad network is no longer as important a factor when they are trying to put together a network that provides reasonable access and availability but at the same time keeps costs down," Osowski says. "Not all plans are adopting the narrow network strategy, but their costs tend to be higher if they don't. It remains to be seen if the narrow strategy will even work, and a lot of that depends on the profile of the people who come into the exchanges and buy insurance. Are they going to select plans based on price or whether their physicians take part in the program?"

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4 comments on "Will Physicians Be Dropped From Managed Care Networks?"

F.H. Netter (2/17/2014 at 4:42 PM)
This is just one more reason the for-profit health insurance system must go. We need single payer and we need it yesterday.

Barbara Ryan (1/23/2014 at 8:09 PM)
Insurers only have to "rein in costs" in order to maintain (or grow) their profit margins. Insurers have been decreasing payments to providers while increasing charges to those they insure for a long time. Obamacare is only the tip of the iceberg of making medical care accessible and affordable[INVALID]insurance industry reform and regulation is also critical.

Doyle (1/23/2014 at 4:48 PM)
Looks like some high quality physicians will draw the higher income patients. Ones that can afford out of network fees. That would be different




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