LAT: HMOs in Unstable Condition: Members Bolt to Other Plans

[DeepModem Mom]

HMOs in Unstable Condition: Members Bolt to Other Plans
Preferred provider organizations offer greater choice, and employers like them because they can shift rising costs to workers.

By Lisa Girion, Times Staff Writer


HMOs, once the top choice for Americans who get healthcare as a job perk, are so last century.

Tightly controlled health maintenance organizations have steadily lost ground over the last decade to preferred provider organizations, which offer greater choice of physicians and hospitals and direct access to specialists — though at a higher price.

HMOs garnered only 25% of the employer-based health benefits market last year, down from a high of 31% in 1996, according to a recent survey by the Kaiser Family Foundation, a Menlo Park, Calif.-based think tank. During the same period, PPOs nearly doubled their market share to 55%.

HMO enrollment in Blue Cross and Blue Shield plans, which cover more than 90 million Americans, has declined steadily since 2001, while the Blues' PPO enrollment has surged. Cypress-based PacifiCare Health Systems Inc., which sells both types of plans, said all of its recent growth was from PPOs....

***

"HMOs have lost their edge," said Sally Pipes, president of the Pacific Research Institute, a San Francisco-based think tank. "Patients were just furious with having to go through gatekeepers to get care from a specialist, so there was this … movement to PPOs."...


http://www.latimes.com/business/la-fi-hmo9apr09,0,3086935.story?coll=la-home-business

[Tandalayo_Scheisskopf]

1. I so look forward...

To the Chapter filing announcements, to be soon followed by the calls for SEC and congressional investigations.

More fodder for 2006.

[0007]

2. Should be out of action soon!

Didn't senator First M.D. have a lot invested in this sleaze ball plan?

[robertarctor]

3. Love the wingnut Sally Pipes quote

That's wingnut Sally Pipes of the wingnut Pacific Research Institute.

Any so-called journalistic endeavor that quotes a wingnut mouthpiece so prominentely is immediately suspect.

More lame agitprop from the Bushist Republic of Jesustan.

[Selteri]

4. This is something the insurance industry had known for over 10 years.

The insurance companies have known this for ten years or more, even when I was in the industry it was obvious that HMO's had more problems than I could count, they hated to even live up to their contractual obligations and seemed to need no end of assistance from people trying to work with thier insurer.

Mind you, all health care is having problems because of these for profit hospitals that have become bastions of corruption. Even with insurance they've always found a way to get some extra money somehow in thier bills.

[nothingshocksmeanymore]

5. Plus HMO's make money by denying care

or withholding it as long as possible

[Conservativesux]

6. PPO plans don't compare to a full HMO plans when you get seriously..

...ill or injured.

Employers are switching to PPO's and even worse, MSA's, as a cost saving measure, nothing more.

HMO premiums are quite expensive right now. PPO's and MSA's much less so.

Get the employer to pay a decent wage, not second or third rate heatlthcare plan that cost more money out of the workers wallet when he/she has to use it.

We need a national heathcare plan for every American NOW, not later!!!!