Short Takes On News & Events

Doctors Groups Share Concerns About Narrow Networks, Confusion With White House

By Phil Galewitz

November 27th, 2013, 11:08 AM

The nation’s top physician groups told White House officials Tuesday they are worried about what consumers will encounter after Jan. 1, when millions are expected to gain coverage under the Affordable Care Act.

Photo by Karl Eisenhower/KHN

The groups expressed worries that patients may unknowingly be signing up for “narrow network” plans that don’t include their current physician or local hospital, said Bob Doherty, a senior vice president for the American College of Physicians.

They’re also concerned about people who switch coverage while in the middle of treatments for cancer and other serious illnesses, which may force them to change providers or prescription drugs.

He also said there were concerns about whether patients might think they have enrolled successfully in plans when they have not. “We talked about whether some people will show up and think they have coverage, but it may not be clear [that] they successfully enrolled in a plan or [that] the health plan got all their information,” Doherty said.

While the meeting was not focused on problems with, some physicians groups did note that the federal portal and other state insurance sites do not make it easy to find out which doctors are in which health plans, Doherty said.

In the hour-long meeting with White House health care advisors Chris Jennings and Jeanne Lambrew, the groups also stressed the need for a permanent change to the Medicare reimbursement formula for doctors, known as Sustainable Growth Rate, or SGR, to avert the annual threat of deep pay cuts to doctors. They also asked to extend the law’s two-year Medicaid pay raise to primary care doctors beyond 2014.

Doherty said the administration officials listened to their concerns. “This was not viewed as a PR exercise,” Doherty said.

Other groups attending the meeting included the American Medical Association, the American Academy of Family Physicians, the American Academy of Pediatrics, the American Osteopathic Association and the American Association of Nurse Practitioners.


6 Responses to “Doctors Groups Share Concerns About Narrow Networks, Confusion With White House”

  1. Ruth Sweeney says:

    This is good. Finally, conversations have turned to the influence that profit-minded insurance companies have on Americans’ healthcare. As long as the focus in on enriching the shareholders (and CEOs, etc), the fox is in the henhouse and patients’ lives count for nothing in the corporate picture.

  2. stan says:

    The nation’s physicians are worried about what consumers will encounter after Jan. 1, when millions are expected to gain coverage under the Affordable Care Act?

    Gee, according to Republicans, nobody is enrolling in the health exchanges, right? According to Republicans, the uninsured are staying away from the health exchanges and would rather take their chances continuing to remain uninsured, right? Isn’t that what we are hearing from Ted Cruz? Isn’t that what Rand Paul from Kentucky is saying? According to Rand Paul, Kentucky is not seeing anyone enroll in the health exchanges, right? Isn’t Rand Paul saying that the health exchange in Kentucky is a complete and total failure? Why would the nation’s doctors be worried about something that, according to Republicans, is not popular and is not going to happen? According to Republicans, every American hates Obamacare, right? According to Republicans, 100 percent of Americans want Obamacare repealed, right? Why would anyone enroll in something that they want repealed? Does that make any sense? In my opinion, doctors should not be worried because, according to Republicans, Obamacare is a 100 percent failure. According to Republicans, nobody is enrolling.

  3. To blame insurance companies and the GOP for the mess is childish. We had a government who’s one goal was to insure everyone and endure the public to this administration.. Nice sounding talking points. The problem is we have no economy, proof of which is the 85 billion a month the fed uses buying bonds to keep it afloat. Second Obama decided to have middleclass America pay for those not insured, when they are barely hanging on. Third to make it seem affordable and to pay for all the bells and whistles, the policy holder was faced with higher cost, higher deductibles and higher co pays and doctors and hospitals with less inclusion in plans because their lifesaving techniques were too costly. Fourth, the administration told untruths about the law in order to pass it. Those getting cancelled is growing faster than those enrolling, backwards. And fifth, and the most important, the American consumer who loved taking care of their families, saw through all of this as a good consumer and now rejects it. What will happen is reduced quality care. One doctor told me that his specialty is too costly for the plan and he is being left out. So how does it feel to have a family doctor take care of a heart problem and not a specialist? Probably not too good, and this is what is wrong with this law. Insurance companies were the intermediaries who took the premiums from willing Americans and transferred it to the health industry and look at all the advances over the years it paid for, and the middle class did this. Now the middle class rejects covering their families at this cost and quality, and these are the ones who are supposed to pay for the plan, not the 21 million Obamacare wants in Medicaid who pay nothing. Perhaps the law is the real problem, not the middleclass the GOP or anyone who sees what this plan really is, a sham for those who want to stay in power and a quality healthcare killer.

  4. stan says:

    Why are you concerned Gerry? Nobody is enrolling anyway, right Gerry? Isn’t that what Republicans are saying? How can Obamacare hurt anyone if nobody signs up? Nobody in Wisconsin needs Obamacare, right Gerry? Nobody in Wisconsin is enrolling, right Gerry? Everyone in Wisconsin is happy with the status quo, right Gerry? Isn’t that what Ted Cruz and Rand Paul and “The Wisconsin Desperado” are telling us? Aren’t they saying that the new health reform law is so unpopular that nobody is enrolling? Tell me Gerry, how can Obamacare hurt America if, as Republicans and the Desperado say, 100 percent of Americans hate Obamacare and are not enrolling? Huh? Gerry? Huh? How come, Gerry?

  5. Annette says:

    I just searched for an article entitled, “CARDIOLOGISTS STRONGLY BACK OBAMACARE, WORRY OVER ROCKY START”. Are any of them Republicans? It’s hard to believe that a Republican Cardiologist could possibly be in favor of Obamacare. How is that possible?

  6. Annette says:

    “Come, you that are blessed by my Father, inherit the kingdom prepared for you from the foundation of the world; for I was hungry and you gave me food, I was thirsty and you gave me something to drink, I was a stranger and you welcomed me, I was naked and you gave me clothing, I was sick and you took care of me, I was in prison and you visited me.”