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Insurer cutbacks squeeze patients out of high-end care
Thousands are left furious, terrified after PPO plans dropped
More than 88,000 people in the Houston area have lost plans from Blue Cross and Blue Shield of Texas for 2016, potentially cutting off some of the most seriously ill from the top-tier medical care the city has built its reputation on.
Last summer, the state's largest insurance carrier dropped all preferred provider organization plans from both the Affordable Care Act's federal exchange in Houston and the private individual market.
Now, with only weeks to go before existing plans expire, patients, doctors and hospitals are scrambling to find what care is available under the insurer's replacement health maintenance organization plans.
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M.D. Anderson, ranked first in cancer care in the nation last summer by U.S. News & World Report, is not covered by a single major insurer on the exchange.
Nationally renowned Houston Methodist and Texas Children's Hospital also are mostly shut out of the federal marketplace by major insurer HMO plans.
snip
Dan Fontaine, executive vice president of administration at M.D. Anderson, has similar concerns about the disappearance of exchange coverage for Houston's prestige medical institutions: "Why so fast? Why so complete?"
"The management of risk used to be handled through denials of pre-existing conditions," he said of pre-ACA days. "It is now being handled through the narrowing of the marketplace."
Insurer cutbacks squeeze patients out of high-end care
Thousands are left furious, terrified after PPO plans dropped
More than 88,000 people in the Houston area have lost plans from Blue Cross and Blue Shield of Texas for 2016, potentially cutting off some of the most seriously ill from the top-tier medical care the city has built its reputation on.
Last summer, the state's largest insurance carrier dropped all preferred provider organization plans from both the Affordable Care Act's federal exchange in Houston and the private individual market.
Now, with only weeks to go before existing plans expire, patients, doctors and hospitals are scrambling to find what care is available under the insurer's replacement health maintenance organization plans.
snip
M.D. Anderson, ranked first in cancer care in the nation last summer by U.S. News & World Report, is not covered by a single major insurer on the exchange.
Nationally renowned Houston Methodist and Texas Children's Hospital also are mostly shut out of the federal marketplace by major insurer HMO plans.
snip
Dan Fontaine, executive vice president of administration at M.D. Anderson, has similar concerns about the disappearance of exchange coverage for Houston's prestige medical institutions: "Why so fast? Why so complete?"
"The management of risk used to be handled through denials of pre-existing conditions," he said of pre-ACA days. "It is now being handled through the narrowing of the marketplace."