More Changes in Healthcare Coverage

It’s not exactly news that the healthcare market is changing. With ObamaCare, the Affordable Care Act, the Exchange and Marketplace, and Accountable Care Organizations, the market is growing in ways that’s hard to understand. How does this affect me? What happens to my care?

Mark Cherry contributed this article to the Healthcare Reform Blog to help spell it out.

Insurers, specifically UnitedHealth, have “slashed hospitals and physicians from its AARP Medicare Complete plans for 2014,” and it’s happening throughout markets around the country.

But why? It actually saves the insurance company and the patient a lot of money, both on the plan and, more often than not, on what’s paid to the medical professional.

However, these changes are resulting in a standoff between insurance companies and hospital networks who usually get tied up in reimbursement negotiations, as that’s the main cost. In response, a lot of hospital networks are joining up with accountable care organizations to make up for the losses.

These changes look to be permanent, as they’re “part of the larger trend toward narrow networks in both the commercial and Medicare space.” The changes have also resulted in higher star ratings for insurance plans after dropping the hospitals.

“Whenever there was an impasse between insurer and provider, the latter always had the advantage because no one understood the actual costs of healthcare.”

Not anymore.

People are educating themselves and really learning to shop around and find the best price, and it’s resulting in better, quality care at an affordable cost.