Re: Re: Politics - Health Care - US

[Guest guest]

RE HMOs and PPOs even for Medicare.

We transitioned further here.

With a dominant insurer BCBS here, we ended up with high penetration HMOs. Then, problems with access, as we have very low retention of new primary care.

When I was "replaced" at my primary care office with a newly minted IM/Peds grad after 8 years, I set up practice on the other side of the city where the employing hospital was.

The dominant insurer by that time was converting MORE to a PPO model, no auths for referrals. AND they pay a "discounted FFS" model, so I got paid for when I saw the pts too.

Working OK for me, esp since July when stopped taking new Medicaid ($31.90 per any visit) and the groups that sold to the hospital get overrun.

Matt in Western PA

Solo FP since Dec 2004

Completed residency in 1988

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