“This furthers the fragmentation of
our health care system. Some of these patients had only been with me 18 months or so and then were switched to a different primary care physician who will have to learn their history and with whom they will have to build a new rap- port and trust from the beginning,” Dr. Bias said. Dr. Bias says he’s hopeful TMA and other state medical societies and orga- nizations can achieve some remedy for physicians and patients who have been distressed by United’s terminations. “From a small practice standpoint, I’m not sure how else we’d seek any solu- tion to this problem. We don’t have the time or resources. That’s what organized medicine can do for us — provide real- world, practical services that make a dif- ference to us practicing physicians,” he said.
A possible trend Dr. Torres says United’s actions signal a trend, and Dr. Lin concurs. “I am concerned that more payers may start to narrow their networks, thinking that they will be able to track quality better or hold doctors accountable bet- ter as a way to achieve cost efficiency. With a narrower network, administra- tive costs may be lower, and they may be able to offer a cheaper product,” Dr. Torres said. “However, will this really translate to better patient care, if pa- tient access is limited with fewer doctors available to see them?” At press time, Aetna began informing
Texas physicians they’d been removed from the network for the company’s health insurance exchange plans. In one letter to a Texas physician, the company cited federal and state requirements to ensure “a wide range of both providers and services” as a factor in forming its new health insurance exchange network. Dr. Torres says it’s more important
than ever that county medical societies and TMA work together to affect change. “Everything physicians do is being monitored and measured by the insur- ance companies these days. HCMS and TMA will be monitoring for threats to the practice of medicine and the doctor- patient relationship. As physicians, our
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