Over 214,000 Doctors Opt Out of Obamacare Exchanges

[scarystuffyo]

I read this on several face book pages and right wing sites today so
I'm not going to link fox news or any other right wing site but if this is true
is it legal for 1/4 of doctors in the country to opt out like this?

[upaloopa]

1. Facebook pages and right wing sites?

Do we know if they ever tell the truth?
May as well post something from wing nut daily to complement your post.

[alcibiades_mystery]

2. ...

[Rex]

31. So true.

Gosh, why would anyone read right wing sites all day and believe them? Sounds like...

[alcibiades_mystery]

33. Of the clown variety in this particular case

Imagine somebody who derives pleasure from this kind of "undercover" nonsense. A pathetic loser, you ask me.

[Rex]

39. What makes it worse imo

is that they come back over and over and over. Is there no bottom to the well of shame? I agree with you 100%.

[jen63]

48. Yup, like we're too dumb to notice.

There's certainly been an influx the last few weeks. Gee, I wonder why...

[dilby]

3. Yes it is legal.

Insurance companies dictate how much they will pay for certain procedures so if an insurance company goes below what the doctor is willing to accept they can opt to not accept patients from that insurance company. Should be noted that the doctor is not opting out of Obamacare they are just not accepting patients from insurance companies who pay below what the doctor feels they deserve. This would probably be the cheapest insurance offerings through the ACA.

[scarystuffyo]

7. The bronze plan?

[dilby]

9. Probably some of the Bronze plans.

But it does not mean all of them, the ACA is made up of multiple insurance companies so it would be like Blue Cross Blue Shield Bronze at $350 compared to No Name CheapO Insurance USA at $170.

[scarystuffyo]

18. Mine might be the cheap o

I pay $215 a month

[dilby]

20. What is the name of your Insurance Company.

If it's a nationally known insurance company you are probably safe? The easiest way you can check is to check with your insurance company's list of approved providers. Also call your provider and ask them, your doctor will let you know.

On edit, your insurance company does not negotiate rates based on your plan level. They pay the doctor the same amount for their Bronze customers as they do their Platinum customers. The difference between the plans is your deductible and services offered not the level of service.

[scarystuffyo]

22. I took the bluecross plan

thanks

[dilby]

25. You are fine, if your doctor stops accepting Bluecross,

They would be shooting themselves in the foot.

[tritsofme]

46. It's my understanding that a doctor could still refuse to accept BCBS Exchange plan

while continuing to accept employer based plans that pay a higher rate.

[unblock]

4. afaik, doctors can choose which insurance they accept and don't accept

[scarystuffyo]

12. If I'm on the bronze plan how do I find out

which plans my local hospital and doctors take ?

Can they say they accept Bluecross but not the blue cross under the ACA because it pays less money to them ?

[Nye Bevan]

21. Yes, they can definitely say that.

You need to check with each doctor or hospital by calling or checking their websites, to check that they accept a Blue Cross EXCHANGE plan (not just a Blue Cross plan). Your policy might also have a "find a provider" feature on its website, but double-check with the provider also.

[scarystuffyo]

24. Thank you

[unblock]

35. you need to know the name of your plan

the carrier might be bc/bs but the plan name might be the "pos" plan or the "freedom" plan or whatever. so, yes, it's possible that they might accept some plans and not others within a carrier.

you can call the doctor or hospital, though they might not care to answer you if you don't have an appointment; or you can check with your carrier. all the major carriers have an online service provider lookup feature online.

[BillZBubb]

5. Facebook and right wing sites NEVER post lies.

So, it must be true!

[Lex]

6. You answered your own question

at least as far as "right wing sites" and "if this is true."

[frazzled]

8. I read on Facebook that

someone using your screen name (whether legally or not) picks their nose and wipes it on the computer. Ewwww, is that true?

[scarystuffyo]

13. This is serious

[alcibiades_mystery]

34. ROFL

[Jim__]

10. Based on a survey of 700 medical groups by MGMA.

I'm not sure who MGMA is or how representative the survey is. The 214,000 number is an extrapolation from the survey, and the question is whether they will be participating in any new offerings of ACA. A link to the survey.

[blm]

11. They opted out of low-cost insurance programs BEFORE the ACA, too.

The difference now is that they can BLAME the ACA, instead of admitting their focus is on healthcare for those who can best afford their services.

[etherealtruth]

45. + infinity!!!!

[Cerridwen]

14. "41.8% of them said it was because no one had asked them to."

From a post regarding this same "issue" on reddit: http://www.reddit.com/r/news/comments/2kq2us/over_214000_doctors_opt_out_of_obamacare_exchanges/

The full post that included other links including one to the survey being twisted:

[–]KennethJohnKelly 2 points 2 hours ago

The author of the original source article based this claim on an MGMA survey taken in April. At that time, 23.5% of the respondents reported that they weren't yet participating in any exchange products.

As of September, there were 893,851 physicians in the US so, voila, 24% of 893851 is ... 214,524 ... and Bob's your uncle!

As bad as that is in itself, the original survey also asked the non-participating docs why they weren't participating. 41.8% of them said it was because no one had asked them to.

Jesus wept.

http://americanactionforum.org/insights/health-care-providers-are-opting-out-of-obamacare-exchang-plans http://www.mgma.com/government-affairs/issues-overview/aca/aca-exchange-implementation-report/aca-surveyreport_online_2?ext=.pdf http://kff.org/other/state-indicator/total-active-physicians

A few snippets from the survey summary (These barely touch the surface. Please read entirety for pertinent details):

MGMA ACA Exchange Implementation Survey Report,
©2014. Medical Group Management Association. All rights reserved.


Summary of Findings

MGMA noted three main themes within the findings.


Obtaining coverage information

Practices have experienced difficulty identifying patients with ACA exchange coverage and obtaining essential information related to that coverage.

<snip>

Patient cost-sharing

Practices are facing a number of challenges related to patient cost-sharing for ACA exchange coverage

<snip>

Network limitations

Practices have concerns about the impact of the network design of many ACA exchange product

[Turbineguy]

30. In the vernacular

Last edited Thu Oct 30, 2014, 07:08 PM - Edit history (1)

that is called "pulling numbers out of your ass."

My survey of my class today revealed that 100% of my students think I'm an idiot. OK, I did not actually ask them, but it might be true! And of course that information is accurate enough for RWNJ's.

[Cerridwen]

36. Yeah. I'd call it outright lying. But yours works, too. :) n/t

[Ykcutnek]

15. I wouldn't believe the right-wing sites if they reported my house was on fire

and I smelled smoke.

[Louisiana1976]

16. America needs single payer. That would be mandatory for all doctors to accept. Unlike our

current greed-based healthcare system where doctors can pick and choose what insurance they'll accept.

[Nye Bevan]

19. I'm pretty sure that it would be unconstitutional to force all doctors to accept single payer,

but I expect that the vast majority would, just like the vast majority accept Medicaid.

[SickOfTheOnePct]

23. Yeah, I don't think they could force doctors to take it

Of course, are there enough people that can pay cash for medical care to keep doctors afloat if they didn't accept single payer?

[BklnDem75]

17. Comically Awful Survey Says 83 Percent Of Doctors Might Quit Over Obamacare

Original article:
Over 214,000 Doctors Opt Out of Obamacare Exchanges

Over 214,000 doctors won't participate in the new plans under the Affordable Care Act (ACA,) analysis of a new survey by Medical Group Management Association shows. That number of 214,524, estimated by American Action Forum, is through May 2014, but appears to be growing due to plans that force doctors to take on burdensome costs. It's also about a quarter of the total number of 893,851 active professional physicians reported by the Kaiser Family Foundation.

http://cnsnews.com/mrctv-blog/barbara-boland/over-214000-doctors-opt-out-obamacare-exchanges

Media Matters article:

Did you know that American doctors are so incensed over Obamacare's big-government communist socialism that more than eight in ten are going to quit doctoring? It's true, according to a terribly conducted survey conducted by a shady right-wing group, reported credulously by the Daily Caller, and hyped by Matt Drudge and Fox News.

"Eighty-three percent of American physicians have considered leaving their practices over President Barack Obama's health care reform law, according to a survey released by the Doctor Patient Medical Association," reported the Daily Caller yesterday. What is the Doctor Patient Medical Association? The Daily Caller didn't seem too interested (beyond calling them "a non-partisan association of doctors and patients&quot so we'll have to fill in a few gaps.

The Doctor Patient Medical Association's founder, Kathryn Serkes, is a long-time veteran of the Association of American Physicians and Surgeons, a collection of crackpot malcontents that opposes mandatory vaccinations, wrongly believes undocumented immigrants spread leprosy, and dabbled in Vince Foster conspiracy theorism. The group itself is solidly conservative in its politics: it boasts membership in the National Tea Party Federation; describes the Patient Protection and Affordable Care Act as "Destruction Of Our Medicine," or DOOM; and published a sheet of talking points about the health law to help grassroots activists "beat back the White House spin machine!"

But what about this improbable survey indicating that more than 3/4 of doctors have considered hanging up the stethoscope rather than tolerate Obamacare? Well, the first thing to point out is that the survey didn't actually ask about the Affordable Care Act. Here's the question and the results as given by DPMA:

http://mediamatters.org/blog/2012/07/10/comically-awful-survey-says-83-percent-of-docto/187029

[SalviaBlue]

26. I had BS (Blue Shield) Silver in CA.

I was provided with a list of providers before I chose the plan and my Doc was on it. I also called my Doc office to double check and they said yes they would accept this plan. So I purchased BS Silver. The premium was similar to what I currently paid for private coverage and similar to what Anthem charged for the Silver Covered CA plan.

In July, I called my Doc for annual ck up and they said they were NOT accepting the plan.

I went online at BS and downloaded the current list of providers and my Doc was now NOT on it. I saw a couple of other Docs I recognized and called for appointment but none of them were accepting this plan.

I registered a complaint with BS to which they never responded.

I called Covered CA and was able to work with a Resolution/Appeals specialist. We determined that most of the names on the provider list were actually not accepting BS. However, I was able to determine that my Doc and many others I checked with accept the Anthem Silver. Fortunately, CoveredCA helped me to change away from BS to Anthem mid-year.

I was told by several of the doc offices I spoke with that they were not accepting BS because the reimbursement was substantially lower for CoveredCA plans (20% lower) than the other BS plans. Anthem is apparently reimbursing the same for CoveredCA plans as non CC plans.

What ends up happening with these small networks is that you end up having to see alot of out of network docs and have to pay 50% instead of 20% and there is no cap.

In summary, yes Doctors are opting out because the insurance companies (Blue Shield in particular) are playing games with networks and doing everything they can to screw providers and patients.

[taught_me_patience]

42. It's 30% lower

and a 30% reduction in revenue easily leads to a 50-70% reduction of net income. The doctors accepting the plans are normally younger and need to build their patient panels. Once the panels are full, you'll see longer wait times, as you'll head to the back of the line to be seen. My wife is a GP that is accepting Covered CA plans and it has reduced her net income. As her panel builds, she'll slowly phase it out.

[SalviaBlue]

47. Its really terrible. I understand that Prop 45

may address this by giving the Insurance Commissioner some oversight powers. Not holding my breath.

Has your wife mentioned the difference in the reimbursement levels between Blue Shield and Anthem. My understanding is that Anthem is higher... just not sure about that.

[mmonk]

27. Yes, true. Glad mine did. I have a better

one now.

[csziggy]

28. A significant number of doctors do not accept Medicare

But that does not mean Medicare is bad. A lot of doctors pick and chose which insurance plans they accept or will in network for. It's a constantly moving target - some years doctors will be in network for certain companies, then other years they won't.

Over half the doctors I prefer to use are not in network for our private insurance - that means that for my knee replacements I had to pay over $10,000 out of pocket. If I had gone to the in network surgeon (who was badly rated on every health care review site I checked) I would have had to pay about half as much out of pocket. I'm lucky that I had the money to use one of the top rated orthopedic surgeons in this area rather than a second rate one.

[JoePhilly]

29. Its nonsense.

The study usually referenced doesn't include that number anywhere in it.

Its an "estimate" based on basically nothing, created by a right wing "policy center".

[coldean]

32. true? not true?

That isn't the purpose of this thread, the question is can doctors opt out of certain insurance plans.
I'm glad it was asked, it is a great question and I for one learned something new rusty
Thanks.

[alcibiades_mystery]

37. How many more right wing bullshit filled posts is scarystuffyo going to post on DU?

Somebody conduct a survey and ask Matt Drudge, stat!

[FSogol]

41. I saw on facebook that pizza is coming....

[taught_me_patience]

38. Covered California plans are reimbursing 30% less than comparable plans

A 30% loss in revenue can easily mean a 50-75% loss in income. Thus, there are not many doctors willing to take that insurance. The doctors who are taking it are seeing a drop in income. When that doctor's patient panel fills up, you'll find that if you are CC, you'll be at the end of the line to be seen.

[FSogol]

40. Only 4 more Ratfucking Days until the Midterms!

[Rex]

43. LOL!

[dlwickham]

44. Doctors can opt out of taking any private insurance or Medicare and Medicaid

it's their right

of course people also have the right to not use those doctors

[SidDithers]

49. Better believe it!...nt

Sid