Clean Sweep Live Auction on Wed. May 1st. Click to view the full inventory

DOTmed Home MRI Oncology Ultrasound Molecular Imaging X-Ray Cardiology Health IT Business Affairs
News Home Parts & Service Operating Room CT Women's Health Proton Therapy Endoscopy HTMs Pediatrics
Current Location:
> This Story

Log in or Register to rate this News Story
Forward Printable StoryPrint Comment




Business Affairs Homepage

Air medical transportation: How a 15-minute ride may cost $30,000, and how we can change it Reducing sky-high transport expenses

Canon's Vital Images wins DoD contract Maximum $100 million fixed‐price contract for radiology and imaging systems

Are you GDPR compliant? It's not just a question for EU-based companies Here are the top eight considerations

Security tightening at hospitals for patient safety A noticeable change is occurring at the front entrance to hospitals

Johnson & Johnson completes Auris Health deal The $3.4 billion acquisition could include additional payments up to $2.35 billion

Follow-up imaging study points to benefits of automated notification Raising the bar on manual callbacks

Change Healthcare files for IPO Could raise as much as $100 million, listing on Nasdaq

Mergers do nothing for quality of care, lower patient satisfaction, says study Based on 29 data points and the assessment of 16 processes of care

GE Healthcare IPO on hold as new deal takes spotlight Selling biopharma business to Danaher for over $21 billion

Asheville Radiology Association joins Strategic Radiology The latest expansion by the imaging coalition brings 43 new physicians to the table

Hospitals are participating in fewer health insurance networks in 2016

by John W. Mitchell , Senior Correspondent
Top hospitals and doctors appear to be limiting the number of insurance plans in which they will participate under the Affordable Care Act (ACA) — and while that may validate claims that the ACA does not foster health insurance price competition, a study out of the Robert Wood Johnson Foundation (RWJF) suggests this trend may simply be part of normal market evolution.

“I actually think it is more positive than negative for the ACA. It shows that access to desirable hospitals remained high in 2016 for marketplace plans, although there is some evidence that it is declining,” Katherine Hempstead, Ph.D., director and senior program officer at the RWJF and study author told HCB News.

Story Continues Below Advertisement


Special-Pricing Available on Medical Displays, Patient Monitors, Recorders, Printers, Media, Ultrasound Machines, and Cameras.This includes Top Brands such as SONY, BARCO, NDS, NEC, LG, EDAN, EIZO, ELO, FSN, PANASONIC, MITSUBISHI, OLYMPUS, & WIDE.

“Most consumers continue to have access to the hospitals and doctors they want through their insurance plan networks, although they might have to pay a little more in some cases," she said.

There has been what Hempstead described as, "much anecdotal information" concerning the allegedly shrinking choice of hospitals and associated health networks. She designed and conducted the study to put a number on any such trend.

Because a federal database is not yet complete due to missing insurer data, she used a data set from the U.S. News & World Report list of best hospitals.

“The current health insurance market does appear to have some headwind,” she said. “The supply for health care might change, but the demand from customers is still there.”

Network participation among hospitals declined more in metropolitan areas of the country, according to Hempstead. Despite that, all the highly ranked hospitals in the U.S News database participated in at least one of the area insurance plans.

According to government statistics, in 2016 12.7 million people signed up for insurance under the Affordable Care Act (ACA) or had their insurance automatically renewed. Most of the sign-ups – 9.6 million - used the federal marketplace.

However, the study may indicate that many of these customers may not have access to top hospitals and doctors. As insurance companies work to negotiate premium prices down, the best providers appear to be opting out of certain plans.

Hempstead’s report noted that changes in insurance plan participation could happen for various reasons. The insurance carrier can become financially insolvent, which was reported in some markets. Or the insurer and the hospitals may not be able to reach financial terms. Also, a carrier may chose not to participation a particular market, such as Cigna’s decision to withdraw from Florida in 2016.

Hempstead told HCB News that the insurance marketplace under the ACA continues to evolve. She said one of the biggest challenges of the ACA for insurers are sign-ups allowed under the special enrollment periods. These can allow consumers to “strategically sign-up” for health insurance when they become ill or drop their coverage in the last two to three months of the year.

“That isn’t really how a group plan is supposed to work,” said Hempstead. “So I think we’ll see some government tweaking of the open enrollment periods in the future.”

Business Affairs Homepage

You Must Be Logged In To Post A Comment

Increase Your
Brand Awareness
Auctions + Private Sales
Get The
Best Price
Buy Equipment/Parts
Find The
Lowest Price
Daily News
Read The
Latest News
Browse All
DOTmed Users
Ethics on DOTmed
View Our
Ethics Program
Gold Parts Vendor Program
Receive PH
Gold Service Dealer Program
Receive RFP/PS
Healthcare Providers
See all
HCP Tools
A Job
Parts Hunter +EasyPay
Get Parts
Recently Certified
View Recently
Certified Users
Recently Rated
View Recently
Certified Users
Rental Central
Rent Equipment
For Less
Sell Equipment/Parts
Get The
Most Money
Service Technicians Forum
Find Help
And Advice
Simple RFP
Get Equipment
Virtual Trade Show
Find Service
For Equipment
Access and use of this site is subject to the terms and conditions of our LEGAL NOTICE & PRIVACY NOTICE
Property of and Proprietary to DOTmed.com, Inc. Copyright ©2001-2019 DOTmed.com, Inc.