The doctor won’t see you? Analysts warn ObamaCare plans could resemble Medicaid

Those signing up for private health care coverage on the ObamaCare exchanges may be in for an unpleasant surprise -- they'll have insurance, but they might have trouble getting the doctor to see them. 

As hundreds of thousands enroll for coverage beginning Jan. 1, analysts are warning that the plans are likely to give them access to fewer doctors and hospitals. So much so, they warn, that the system could begin to resemble Medicaid, the health care program for low-income Americans. 

"Indeed, I think this will eventually be like Medicaid," said Merrill Matthews, director of the Council for Affordable Health Insurance. 

Matthews said the only way many insurers are going to be able to control costs is by "simply clamping down on the amount they are willing to pay." 

Just as with Medicaid, analysts warn that if payments get too low, many doctors might start refusing to see patients. That will leave more and more patients jockeying to see fewer and fewer doctors. 

They emphasize, then, that having health insurance won't necessarily translate into access to health care. 

"About half of the physicians in many communities refuse to take Medicaid patients because the payment system is just too low," said James Capretta, of the Ethics and Public Policy Center. 

Doug Holtz-Eakin, former director of the Congressional Budget Office, suggested some of the plans on the exchanges are going in the same direction. 

Via: Fox News Politics

Continue Reading....

More than 2,200 Hospitals Face Penalties Under ObamaCare Rules

A provision of ObamaCare is set to punish roughly two-thirds of U.S. hospitals evaluated by Medicare starting this fall over high readmission rates, according to an analysis by Kaiser Health News.

Starting in October, Medicare will reduce reimbursements to hospitals with high 30-day readmission rates -- which refers to patients who return within a month -- by as much as 1 percent. The maximum penalty increases to 2 percent the following year and 3 percent in 2014. 

Doctors are concerned the penalty is unfair, since sometimes they have to accept patients more than once in a brief period of time but could be penalized for doing so -- even for accepting seniors who are sick. 

"Among patients with heart failure, hospitals that have higher readmission rates actually have lower mortality rates," said Sunil Kripalani, MD, a professor with Vanderbilt University Medical Center who studies hospital readmissions. "So, which would we rather have -- a hospital readmission or a death?"

But according to federal government figures, nearly one in five Medicare patients is readmitted to a hospital within 30 days of release, costing taxpayers an estimated $17.5 billion.

"Readmissions has been a low-hanging fruit for Medicare," said Jordan Rau, a staff writer with KHN, an editorially independent program of the non-partisan Kaiser Family Foundation. "They've been very unhappy that about 2 million Medicare beneficiaries are being readmitted every year between 30 days of discharge."

Medicare evaluated readmission rates at 3,367 of the nation's hospitals and will impose penalties on 2,211 starting in October, according to KHN. The analysis shows 278 hospitals will receive this year's maximum penalty of 1 percent. On the other side of the spectrum, 50 hospitals will receive the minimum penalty of 0.01 percent, KHN reports.

Via: Fox News

Continue Reading...