Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
Old 11-23-2015, 07:39 PM   #61
Thinks s/he gets paid by the post
photoguy's Avatar
 
Join Date: Jun 2010
Posts: 2,301
Quote:
Originally Posted by utrecht View Post
What is the point of shrinking networks? Almost nobody is going to use a doctor who is not in their network so how are these doctors who are being taken out of networks making money?
I think it's more of a cost cutting technique by the insurers. I.e. they only include the providers that accept the lowest payments (perhaps in return for more patient volume). Also if wait times go up, I'd assume that results in saved money as well.
__________________

__________________
photoguy is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 11-23-2015, 08:30 PM   #62
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
audreyh1's Avatar
 
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 16,535
Quote:
Originally Posted by utrecht View Post
What is the point of shrinking networks? Almost nobody is going to use a doctor who is not in their network so how are these doctors who are being taken out of networks making money? It would be like a shoe store who will not sell shoes to anyone whose name starts with A, B, C or D....then next year they also eliminate E, F, G and H. Eventually they will go bankrupt.
Individual insurance has the shrinking networks. The group insurance that employees have, still has access to the broad PPO networks.
__________________

__________________
Well, I thought I was retired. But it seems that now I'm working as a travel agent instead!
audreyh1 is offline   Reply With Quote
Old 11-24-2015, 12:27 PM   #63
Thinks s/he gets paid by the post
Gotadimple's Avatar
 
Join Date: Feb 2007
Posts: 1,764
Quote:
Originally Posted by utrecht View Post
What is the point of shrinking networks? Almost nobody is going to use a doctor who is not in their network so how are these doctors who are being taken out of networks making money? It would be like a shoe store who will not sell shoes to anyone whose name starts with A, B, C or D....then next year they also eliminate E, F, G and H. Eventually they will go bankrupt.
As Katsmeow pointed out the doctors contract with several/many insurers.

For insurers, a limited network is a cost control technique. They are contracting with providers who have agreed to a lower rate for a higher patient flow. The provider is agreeing they have the capacity to see more patients (and with some HMOs to cap the number of patients they can see) for a lower reimbursement.

Providers (doctors, labs, and hospitals) have been at this 'dance' for many years now and know the techniques to assure they have patient flow at a rate that lets them cover overhead and make a profit.

- Rita
__________________
Only got A dimple, would have preferred 2!
Gotadimple is offline   Reply With Quote
Old 12-01-2015, 07:11 AM   #64
Full time employment: Posting here.
 
Join Date: Jan 2014
Posts: 663
FYI, but MD Anderson Cancer Ctr is not in their PPO network.

Quote:
In Houston, the only plans available through the federal exchange have closed networks. Blue Cross Blue Shield of Texas, which offered a PPO plan in Houston for 2015, cited rising costs as a reason it will not offer any open access plans next year. There is at least one PPO that consumers can purchase directly or through a broker, offered by the Memorial Hermann Health System, but it is not listed in the federal marketplace offerings so premium subsidies are not available.
Source: http://ifawebnews.com/2015/11/30/as-...ives-increase/

From the Memorial Hermann Health website:
Quote:
HMO Service Area: Harris, Fort Bend and Montgomery counties.
PPO Service Area: Harris, Fort Bend, Montgomery, Brazoria, Galveston, Walker and Wharton counties.
For individuals, find the rate that matches your age for the plan you’re interested in.
For families, find the rate that matches the age for all members of your family and add them together. If you have more than three (3) children, only add the rate for the three (3) oldest up to age 26.
The PPO is a Limited Hospital Care Network.
Source: Bronze Plans

Provider Network Search: http://healthplan.memorialhermann.or...rchfor=doctors
Rate Quotes: Individuals and Families Get a Quote
__________________

__________________
MBSC is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Medical Insurance - CDHP vs PPO Sanity Check Request prototype Health and Early Retirement 2 10-26-2013 03:10 PM
Canceling rewards card before fee kicks in? Amethyst FIRE and Money 19 11-19-2012 09:50 PM
PPO,POS,or HMO??? aaronc879 Health and Early Retirement 17 02-08-2012 04:30 AM
Canceling unused credit cards - effect on FICO Lakewood90712 FIRE and Money 10 10-16-2011 03:50 PM
Canceling collision/comprehensive on our cars WanderALot Other topics 13 03-09-2007 09:01 PM

 

 
All times are GMT -6. The time now is 09:42 PM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.