BUSINESSED doctors protest Blues payment shiftEmergency physicians in Massachusetts say the insurer's decision to put payments in patients' hands will be a burden for both plan members and doctors.By Robert Kazel, amednews staff. Feb. 7, 2005. Boston-based BlueCross BlueShield of Massachusetts, the state's biggest health plan, instituted a new policy at the start of 2005 under which reimbursements for emergency physicians' professional fees will be mailed directly to patients if a medical group isn't part of the Blues network. Patients will be asked to pay the physicians in turn. BlueCross already has 90% of the emergency physicians in the state in its networks. The groups that are not -- representing 10 hospitals in the state -- always have received direct payment for their services. Many doctors are accusing the Blues plan of making a blatantly calculated decision to try to force them to accept discounted HMO and PPO fee schedules. The change, they say, will be both burdensome for physicians and perplexing for many patients. Donald Hansen, MD, head of the ED at Jordan Hospital in Plymouth, Mass., said his group of 14 emergency physicians negotiated with the Blues last year for better fees, but the fees were lower than those offered by other plans in the market. "They wouldn't budge," Dr. Hansen said. "You can't support a full staff of emergency room physicians on what they were offering. They're just trying to strong-arm their emergency room physician groups." [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2005 American Medical Association. All rights reserved.
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