What will happen now?

[Guest guest]

Companies are laying off people and filing bankruptcy seemingly

overnight (See circuit city). With these changes, it would seem to me

that medicaid traffic would increase as their ranks swell and there are

no barriers to see the doctor about depression from losing a job. I

have already heard my fellow doctors that PPO patients are reducing

their visits due to less money.

I am still employed per diem with an urgent care where all we are

seeing is the 0 copay patients. Nobody else is trying to get " urgent "

care.

I am in negotiations with an HMO contract but think that their numbers

might also be shrinking because mostly employees of medium to large

companies get HMO. Most small business owners (myself included) prefer

PPO. Does anybody in this group even deal with HMOs or considering it?

If so share your thoughts.

[Guest guest]

BCBS in our area with HMO contracts are paid "fee for service" meaning pt pays copay, and insurer pays for the visit at negotiated rate less the copay.

If pt goes to another doc, then no coverage.

We check coverage first time if no card and don't see unless we are primary.

Straight capitation only with about a dozen Aetna pts (at most) but biggest issue they pay me cap of about $3/month, a joke.

Straight capitation no longer useful. CAREful here.

Matt in Western PA

Solo FP

What will happen now?

Companies are laying off people and filing bankruptcy seemingly overnight (See circuit city). With these changes, it would seem to me that medicaid traffic would increase as their ranks swell and there are no barriers to see the doctor about depression from losing a job. I have already heard my fellow doctors that PPO patients are reducing their visits due to less money. I am still employed per diem with an urgent care where all we are seeing is the 0 copay patients. Nobody else is trying to get "urgent" care. I am in negotiations with an HMO contract but think that their numbers might also be shrinking because mostly employees of medium to large companies get HMO. Most small business owners (myself included) prefer PPO. Does anybody in this group even deal with HMOs or considering it? If so share your thoughts.

[Guest guest]

$3 cap a month? Wow, that's less than us! We get TWICE what you get. ha ha so there. yep. a Whopping $7 a month.

Isn't capitation rediculous? We all need to get off of that junk.

Our biller says that if you talk to Aetna you can take the plan as non-capitated. I'm having her look into it for us.

To: Sent: Saturday, November 15, 2008 12:41:29 PMSubject: Re: What will happen now?

BCBS in our area with HMO contracts are paid "fee for service" meaning pt pays copay, and insurer pays for the visit at negotiated rate less the copay.

If pt goes to another doc, then no coverage.

We check coverage first time if no card and don't see unless we are primary.

Straight capitation only with about a dozen Aetna pts (at most) but biggest issue they pay me cap of about $3/month, a joke.

Straight capitation no longer useful. CAREful here.

Matt in Western PA

Solo FP

[Practiceimprovemen t1] What will happen now?

Companies are laying off people and filing bankruptcy seemingly overnight (See circuit city). With these changes, it would seem to me that medicaid traffic would increase as their ranks swell and there are no barriers to see the doctor about depression from losing a job. I have already heard my fellow doctors that PPO patients are reducing their visits due to less money. I am still employed per diem with an urgent care where all we are seeing is the 0 copay patients. Nobody else is trying to get "urgent" care. I am in negotiations with an HMO contract but think that their numbers might also be shrinking because mostly employees of medium to large companies get HMO. Most small business owners (myself included) prefer PPO. Does anybody in this group even deal with HMOs or considering it? If so share your thoughts.