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Some NYC Hospitals Not Taking New Health Plans


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#1
AugustWest™

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http://abcnews.go.co...-plans-20956793

 

 

New Yorkers buying a health plan on the state's new insurance exchange should read the fine print if they're interested in getting care at some of the city's top hospitals.

Not all are participating in the new plans created by the Affordable Care Act.

As of this week, not one of the plans for sale on New York's health benefit exchange would cover treatment at Memorial Sloan-Kettering Cancer Center, one of the world's largest and most respected cancer hospitals.

That could mean that the 615,000 individuals and 450,000 small business employees expected to eventually get their insurance through the exchange would have to go someplace else for treatment, or pay the bill out of their own pockets.

Other premier city hospitals are in the networks of just a few of the new plans.

NYU Langone Medical Center has signed agreements with four of the 19 insurers doing business on the exchange.

NewYork-Presbyterian Hospital, which oversees the city's biggest hospital system, has signed agreements with six insurers.

President Obama promised when the Affordable Care Act was enacted that people who liked their doctors could keep them, but the reality of the law both in New York and around the country is that the new, lower-cost policies it is creating sometimes have smaller provider networks than Medicare, Medicaid, or the plans people typically get through their employers.

Those narrower networks are a result of insurers trying to control costs and hospitals being cautious about agreeing to take new, untested insurance products.

A spokeswoman for NYU Langone, Lisa Greiner, said the hospital was taking a "semi-conservative" approach to participation and working only with insurers with "strong records in resolving enrollment and payment issues."

The hospital also chose not to work with insurers that wanted to include the hospital, but not its doctors, in its treatment networks.

Negotiations at several hospitals were ongoing, and it is possible some insurer networks will grow by the time policies take effect on Jan. 1.

Sloan-Kettering spokeswoman Caitlin Suzanne Hoo, said Wednesday that the hospital was still talking with insurers.

"We want to be accessible and expect to be in network with one or more ACA plans," she said. She added that patients currently undergoing care shouldn't worry about a disruption. "We would never stop a patient's treatment because of a change in insurance or financial situation."

Empire Blue Cross and Blue Shield, one of the health plans that failed to reach an agreement with Sloan-Kettering, didn't directly address why things hadn't worked out, but hinted that cost was a factor.

"Our choices relating to network composition have been motivated by our goal of supporting access to a broad range of care on an affordable sustainable basis," spokeswoman Deb Wiethop said in an email. "Affordability is key to a more focused network."

Founded in 1884, Sloan-Kettering was the first hospital in the world dedicated solely to treating cancer. The faculty includes winners of prestigious science prizes. Its clinical research program is one of the country's largest.

 

 

Looks like Obamacare should be great for americans....

 

 

 

as long as they don't want top flight cancer treatment.

 

"we want americans to have the best and most affordable healthcare available" (just don't do it at Sloan-Kettering)

 

 

 

i'm not against healthcare for all..

 

but can we at least do it in a professional and thought out way instead of rushing through some bill created to make the big insurance companies even richer? and maybe have the people who vote on it actually read and comprehend it?

 

is that too much to ask?


Edited by АugustWest, 23 November 2013 - 08:55 PM.

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#2
goober0331

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I think this is the same thing, havent watched it in awhile though, but its related!


Edited by goober0331, 23 November 2013 - 10:01 PM.


#3
AugustWest™

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as long as no one gets cancer we should be all set..



#4
Judgement

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While I understand all the fuss. Some hospitals not taking this or that insurance plan is nothing new. Was talking to this girl last year who has medicaid and out of the 3 closest hospitals she couldn't go to any of them, she had to go to the 4th hospital I would have never even thought of...and definitely wouldn't have thought of going to if I was standing in front of the place holding a bag of ice with 5 of my severed fingers inside it lol

Edited by Judgement, 24 November 2013 - 04:01 AM.


#5
garrison68

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#6
mandrin13

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I dont need to get involved in another Obamacare thread, there are already too many.  Deleted


Edited by mandrin13, 24 November 2013 - 04:58 PM.


#7
AugustWest™

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I don't know if my current (non-Obamacare) private insurance pays for Sloan Kettering, but I don't mind paying 50% less for Obamacare, even if it means less choices - which may be only temporary as it said in the OP article, the hospitals are proceeding with caution during the initial phases of Obamacare.   

 

but i thought we're automatically getting better care? You've been saying this for months now.

 

now you're satisfied with cheaper rates and sub par coverage?

 

This is the exact opposite of what Obamacare is supposed to be.. so rich people can go to Sloan Kettering and people who use the exchanges have to settle for less?

what exactly has changed??

 

if you have any decent policy from a major carrier than Sloan Kettering will accommodate you. My $208/month Aetna policy is accepted at Sloan Kettering btw. (hopefully i'll never have to put it to the test)

 

agan.. i'm not against getting everyone the healthcare that they need.. even if the "rich peple" need to kick in more.

 

but the way this went down with the major insurance giants making the rules and the lawmakers pushing for and against it without having even read it, is absolutely unacceptable.


Edited by АugustWest, 24 November 2013 - 05:02 PM.

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#8
garrison68

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#9
AugustWest™

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One example of why it is likely to be better with Obamacare is there will no longer be one or two million dollar caps on treatment,to me this is worth the trade offs for exchange plans.   The turning down of people with preexisting conditions, by the insurance companies, is also no longer an issue.  

 

Obamacare as it is right now is not a panacea, and if I ever hat impression then that's my mistake - but I think that it will have considerably more positives than negatives in the long run, if it's tested and tweaked.  

 

why tweak and not just take your time and put out a product that works? Read the bill.. then tweak it, then vote on it.

 

this isn't windows.. it's health care.


Edited by АugustWest, 24 November 2013 - 11:57 PM.

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#10
wtc

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You know with so much opposition to this law you think they might rethink it..

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#11
garrison68

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#12
Runningw235

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Premiums could go up an average of 500%, and garrison would defend it to the death.


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#13
AugustWest™

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The various lobbyists and corporations aren't going to agree on everything, and some of it already got ditched several years ago.   

 

Just to play Devil's Advocate for a moment, if they had not rushed it the windows of opportunity to pass it wouldn't have remained open very long.  

 

why do lobbyists and corporations need to be involved in our healthcare? do they really care about our health?


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#14
Runningw235

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why do lobbyists and corporations need to be involved in our healthcare? do they really care about our health?

 

We need them to save us from the other lobbyists and corporations! Duhh!!!


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#15
garrison68

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#16
forty winks

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why do lobbyists and corporations need to be involved in our healthcare? do they really care about our health?

That's a radical concept in the US but plain common sense in many other countries.






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