Jameson Health System on Tuesday said it plans to merge into the UPMC network as soon as the beginning of next year. In a joint news release, the New Castle-based health system and UPMC announced board members have signed a nonbinding letter of intent, which they hope to finalize by the first quarter of 2015. Officials on Tuesday said the goal of the merger is to create a regional approach to health care by integrating the boards and strategies at Jameson in Lawrence County and UPMC Horizon in Mercer County.
MVP Health Care, an insurer based in Schenectady, New York, is dropping some of its plans tied to Medicare and raising rates for other related coverage under the health care program for elderly people. Denise Gonick, president and CEO of MVP Health Care, delivered the announcement during a news conference this morning. She also said the Schenectady-based insurer with about 700,000 members in New York is projecting it will run at a deficit in 2015 because of the issue. Gonick said the decision was prompted in part by reduced reimbursement payments tied to Medicare, the federal program generally covering people age 65 and above.
Over the summer, Alzheimer's patient John "Pete" Barwick had a stroke, fell and hurt his hip. On top of this, wife and caretaker, Karen Barwick, was dealing with some unexpected bad news. Their insurance company, UnitedHealthCare, had dropped her husband's neurologist of five years from their Medicare Advantage plan. In fact, UnitedHealthCare had sent out letters to customers all over the state telling them their doctor had been dropped. The company won't disclose how many letters went out or how many doctors were cut. Medicare Advantage is insurance from a private company which contracts with Medicare to provide federally administered Medicare benefits, usually with some enhanced benefits for a price.
When parents brings kids to Phoenix Children's Hospital, their concerns often extend beyond medical care to what they are entitled to under their health-care coverage, be it an employer's plan or the state's Medicaid system. To ease that confusion, the hospital now offers Family Financial Services, with a team of certified counselors ready to help with those questions. Laura Handy-Oldham, the hospital's director of patient access, said the goal is simple: "No surprises." "We have a team that works all of the benefits and all of the eligibility up front, and they work hand in hand with our Family Financial Services team to reach out to the family beforehand so that they know what's expected of them," she said.
About half of charges billed by doctors at an emergency room of a hospital in a network of one of Texas' three largest insurers are billed as out-of-network services because the doctor is contracted, the report found. For the state's second-biggest insurance company, UnitedHealthcare, more than two-thirds of ER charges at in-network hospitals are billed as out-of-network, according to the report. And nearly half of the hospitals technically in that network actually have no in-network ER doctors. "Even if you are a very sophisticated customer and try to choose hospital A over hospital B based on network, you can't control who sees you," said Stacey Pogue, the report's author. "It's a total roll of the dice." [Subscription Required]
The Obamacare open enrollment season begins in just two months. While HealthCare.gov is unlikely to melt down like last year, consumers still may face some complications. Getting those who signed up this year enrolled again for 2015 won't be as easy as it might seem. And the law's interaction between insurance and taxes looks like a sure-fire formula for confusion. For example: The roughly 8 million people who signed up for Obamacare this year are set up for automatic renewal, but those consumers risk sticker shock by missing out on lower-premium options. Additionally, if a consumer's income changed in the past year, they could get stuck with an outdated and possibly incorrect government subsidy.