"Modest" profit? Doctors reimbursements are already a "done deal"....the state of California continues their investigation into Blue Cross....BD
SAN DIEGO ---- Looming reimbursement cuts from Blue Cross of California could mean that doctors will be spending less time with patients, a local doctor said last week.
Reimbursement rates are what insurers pay contracted doctors for specific services ranging from routine office visits to surgical procedures and everything in between.Officials for Blue Cross, the second largest private insurer in California and third largest in San Diego County, said they had cut some reimbursement rates but increased others. They also said that they were cutting rates to protect customers by keeping health insurance as "affordable as possible" while earning a modest profit.
Mazer said doctors are particularly unhappy because they, and consumer groups, believe that Blue Cross is cutting what it'll pay doctors and jacking up premiums for patients and shipping the profits out of state. Jerry Flanagan, health care policy director with the Foundation for Taxpayer and Consumer Rights, testified that Blue Cross had shipped $6.5 billion out of the state between 2004 and 2006.
Flanagan, however, said that Blue Cross had been hiding other payments by shipping them to sister companies under the guise of doing work for Blue Cross.What might be more likely than doctors quitting, Mazer said, is that patients will feel the "trickle down" effect.
But Schmidt said the agency had no control over the doctors' reimbursement rates.
"Yeah, those are a done deal," Schmidt said.
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