Patients Panic as Hospitals and Insurers Clash Over Contracts, Risk of Losing Doctors Looms

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ICARO Media Group
News
02/03/2024 21h12

In a major battleground between hospitals and health insurers, up to 100,000 people may soon realize that the promise of "keeping your doctor" under Obamacare may no longer hold true. Contract disputes between these entities have put patients in jeopardy, causing panic and uncertainty among those at risk of losing their insurance coverage of their doctors.

Ominous letters and emails have been flooding patients' mailboxes and inboxes, delivering the news of imminent physician coverage loss. Caught in the crossfire, patients are left bewildered and flooded with questions, resulting in a surge of calls to doctors, increased appointments, and a rise in complaints on social media.

One of the battlegrounds for this conflict is in New York City, where health insurers such as UnitedHealthcare and Aetna are locked in a sparring match with renowned hospital systems like NewYork-Presbyterian and Mount Sinai Health System. The hospitals are seeking higher payments for the treatment provided by their doctors, while insurers argue that these demands are unjustifiable.

NewYork-Presbyterian accuses the insurer of not offering sufficient compensation, while Aetna claims that the hospital system's demands are untenable. Both parties have refrained from disclosing the specific rate increases being sought. In the event of failed negotiations, patients can not only lose all or part of their health plan's coverage but may also be subjected to higher, non-negotiated rates set by the doctors.

Mount Sinai Health System states that rising labor costs and its analysis of hospital pricing data have prompted the need for new contract terms. The system's chief managed-care officer, Brent Estes, highlights that Mount Sinai has been comparatively underpaid in relation to its competitors. On the other hand, UnitedHealthcare cites an alarming potential increase of 43% to 58% in rates over three to four years if Mount Sinai's proposals are accepted, emphasizing the need for an affordable and sustainable agreement for the benefit of New Yorkers and employers.

As the population ages, the demand for medical care services is expected to skyrocket. Recent data shows that between 2019 and 2023, there was a 3.0% increase in the population, while the federal debt rose by 45.3%. In comparison, between 2007 and 2019, the federal debt surged by 105.3%, while the population witnessed an 11.8% increase.

These statistics indicate a looming cost crisis in healthcare. In light of this, future articles will delve deeper into the issue, presenting new charts from a Consumer Price Index (CPI) perspective.

To stay updated on this ongoing conflict and other related news, readers are encouraged to subscribe to MishTalk Email Alerts. Subscribers will receive email notifications for each new post and have the option to unsubscribe at any time. This article originally appeared on MishTalk.com.

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The views expressed in this article do not reflect the opinion of ICARO, or any of its affiliates.

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