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Health Insurance Exchange Blasted Over Primary Care Access in Massachusetts

Cheryl Clark, for HealthLeaders Media, August 5, 2010

The company contracted to provide care for 30,000 legal Massachusetts immigrants and a spokesman for the state's health insurance exchange, Health Connector, harshly criticized a letter in Thursday's edition of the New England Journal of Medicinethat says those patients are being denied physician access.

"We believe that patients who were switched from Commonwealth Care to CeltiCare had inadequate access to primary care three months into this new program," Ruth Hertzman-Miller, MD and colleagues with the Cambridge Health Alliance (CHA), a CeltiCare competitor, wrote in a letter published in the Correspondence section of the journal.

Hertzman-Miller's letter states that according to CHA's telephone survey during the second and third months of the Commonwealth Care Bridge Program earlier this year, the for-profit insurance company CeltiCare's provider network listed 326 providers within a five-mile radius of the former providers, Boston Medical Center and CHA.

Of those, 119 were duplicates, and 25% could not be reached at the telephone number provided. Of those available by phone, only 37% were actually accepting new CeltiCare patients. The average wait, the letter says, was 33 days.

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