In a recent article, Medical Economics reports that UnitedHealth is cutting at least 15% of physicians from its Medicare Advantage plans. As one of the nation’s largest insurance companies, this means thousands of doctors, and their patients, are being directly affected by the cuts.
“We are working to collaborate with a more focused network of physicians to help us provide higher quality and more affordable health care coverage to meet the needs of our members, and help them get more from their health plan benefits,” said UnitedHealth CEO Jack Larsen to the New York Post.
While this is obviously a boilerplate response, let’s take a closer look at it. The “focused network” part of the statement suggests that UnitedHealth is opting for quality over quantity. But for many patients, the cuts mean less access to specialists, longer wait times for care, and in some cases, having to travel out of the area for treatment. With a large number of Medicare Advantage members being elderly, none of this sounds like a quality option.
An interesting aspect to contemplate is the seemingly arbitrary nature of the quality requisite. The Hartford Courant reports that doctors cut from the Medicare Advantage network are still being kept a part of UnitedHealth’s network for commercial healthcare plans. So quality clearly is not the issue.
Under the Affordable Care Act (ACA), relationships between physicians and insurance companies are becoming tenser than ever. UnitedHealth is not the only insurer to kick out the doctors that don’t fit the bill, but they are the first ones doing so at a larger scale.
The real issue, of course, is money. Over the next 10 years, $156 billion is being cut from the Medicare Advantage program. The President’s promise that everyone would be able to stay with their current plan under the ACA turns out to be a tough one to keep when insurance companies and doctors alike refuse to take a pay cut.
Patients, who ultimately end up being the ones paying the price, are left with three main options: keep your current plan but find a new doctor, change plans to keep your doctor, or pay out of pocket.
Coverage for UnitedHealth members may end up being more affordable after the cuts, but with fewer doctors seeing more patients, it’s hard to believe that the quality of care will not suffer. In the face of a primary care physician shortage, the logical answer should be more connected providers, not less.