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Questcor Pharmaceuticals, Inc. (QCOR) Message Board

  • willmikeycare willmikeycare Nov 16, 2013 11:42 AM Flag

    Docs getting dropped

    For costing insurance too much!

    And so it begins...

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    • UnitedHealth drops thousands of doctors from insurance plans: WSJ

      (Reuters) - UnitedHealth Group dropped thousands of doctors from its networks in recent weeks, leaving many elderly patients unsure whether they need to switch plans to continue seeing their doctors, the Wall Street Journal reported on Friday.

      The insurer said in October that underfunding of Medicare Advantage plans for the elderly could not be fully offset by the company's other healthcare business. The company also reported spending more healthcare premiums on medical claims in the third quarter, due mainly to government cuts to payments for Medicare Advantage services.

      The Journal report said that doctors in at least 10 states were notified of being laid off the plans, some citing "significant changes and pressures in the healthcare environment." According to the notices, the terminations can be appealed within 30 days.

      Tyler Mason, a UnitedHealth spokesperson, was not immediately available for comment when reached by Reuters.

      The insurer told the WSJ that its provider networks were always changing and that it expected its Medicare Advantage network to be 85 percent to 90 percent of its current size by the end of 2014.

      UnitedHealth is participating in about a dozen new state insurance markets that launched on October 1 to offer subsidized health coverage under President Barack Obama's healthcare overhaul.

      The insurer said previously it planned to withdraw from some markets in 2014 because of the government funding cuts.

      Another top health insurer, Aetna Inc , also warned in October that it expected slowing growth in 2014 in its Medicare Advantage plans.

      Sentiment: Strong Buy

    • How does this affect Questcor? Most doctors cost a lot. You have been saying for months that Obamacare should not have much of an effect on Questcor or maybe even a slight positive benefit.
      Cryptic and morose postings be gone!

      • 2 Replies to white_kiku
      • Let's be precise, I said it should have little to no impact, or possibly a slight positive impact in the short term. However, since last November I warned of the long term potential impact. Also I stated that depending on how they play it, the impact could be muted while they dance with new indications which target different population groups that rely on different types of insurance which may change at different rates.

        Of course this was all met with Maxxie screaming his usual blather, so the sheep may not have heard.

        Other than that, don't care as I will play it up or down.

      • One word: Dislocation.
        I recommend you read some Milton Friedman regarding gov't intervention into the free markets as well as self interests.. A good book to work through is Road to Serfdom.. The fundamental transformation of health care delivery has begun, and it is going to get much worse... Brace for impact.

    • They are being dropped out of Medicare Advantage programs, primarily. As you know these programs were heavily promoted when they were first introduced. Insurance companies would sponsor free information sessions which would include lunch or dinner at a local restaurant or diner. These plans were a bonanza for the insurance companies and in almost all cases the medicare recipient signing up would have their medicare premiums taken directly out of their social security monthly payments as is the case with traditional Medicare. I, for one, was always leery of these plans and opted to stay with traditional Medicare and a supplemental policy. The roadway to good medical care, especially for seniors and or anyone with a chronic illness, can be strewn with many daunting roadblocks. Unless, of course, you are in the category of free premiums, subsidized by the government ala the White House. Of course we are the ultimate source of the payments. Naturally many medical providers as well as hospitals are opting out of the Obamacare skullduggery. So of course many of these newly enrolled people will end up back on the doorstep of the emergency rooms.

      Sentiment: Strong Buy

      • 2 Replies to drdonrs
      • " Naturally many medical providers as well as hospitals are opting out of the Obamacare skullduggery. So of course many of these newly enrolled people will end up back on the doorstep of the emergency rooms. Less"

        Why would any provider reject a patient for having insurance?
        These ins. plans are from the same insurers.
        All the doctors and hospitals want to know is who to bill for services.
        They don't bill Obamacare, and that's not relevant except for selecting an insurer from a central location.

      • Doc,
        No offense but that was a lot of words without saying much. I don't even disagree with anything you said. None of it is relevant though.

        Stage 3 of the 4 stages of stricter UM is now starting. I laid this out last year when I was explaining what all the coverage doc changes were and why. These are the 4 things that have to happen for insurance companies to contain costs for an obamacare era.

        Like most things, small steps are taken with low hanging fruit and then the same but bigger changes occur.

        The big changes will happen. Docs are going to realize that very few have any power and were spitting into the wind when complaining or refusing patients

        It has begun...

 
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