High premiums may mean some patients can't afford their physicians

3 strategies to improve hospital cost containment, cash flow

Rises in the cost of insurance premiums may force consumers to choose between keeping their current provider and saving money, according to a report from Kaiser Health News.

Consumers in California are looking at stiff premium hikes averaging 13.2 percent across the state in 2017FierceHealthPayer has reported. On the plus side, “most consumers have the ability to insulate themselves from premium increases and keep their monthly costs level from the previous year,” says Caroline Pearson, senior vice president with the health policy consulting firm Avalere Health. Doing so could mean a new insurance plan, however, and that could mean patients must change doctors if the practice doesn’t participate in the new plan.

The situation may not be ideal, but it’s an ongoing component of market-based insurance, and Kaiser Health News notes that such difficult choices existed before the advent of the Affordable Care Act. The exchanges offer consumers an annual opportunity to change their options, but Tom Freker, a California insurance broker, says most of the time people aren’t particularly interested in shopping around because both doctors and patients put a good deal of stock in their relationships.

California’s rate hikes have been lower than in most states in recent years, which has led to significantly less churn among patients: only 14 percent of enrollees in the California exchange changed plans in 2016, compared to 43 percent in the exchange run by the federal government, HealthCare.gov, according to the article. A spokesman for Covered California pointed out that consumers who change their plans won’t necessarily be forced to change doctors, though he conceded it could be an issue for some patients. 

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