Recently a New York Times article noted: If you “… are stuck with a surprise bill, patients will be responsible only for whatever their co-pay would be if the doctor were in-network.”
Here’s a Q&A from Kaiser Health News:
“Q. My doctor added on a charge for a “chronic disease management” appointment on top of my annual physical because I have thyroid disease and arthritis. The doctor’s office explained that my visit was more complicated than a routine physical. I’m not sure I buy that. In my case, it only cost a $20 copay, but I was surprised that it was billed that way, and it could be a surprise for someone without the excellent coverage that I have. Can they do that? ”
A recent Wall Street Journal article noted: “An increasing number of practices are scrapping the traditional one-on-one doctor-patient relationship. Instead, patients are receiving care from a group of health professionals who divide up responsibilities that once would have largely been handled by the doctor in charge. While the supervising doctor still directly oversees patient care, other medical professionals—nurse practitioners, physician assistants and clinical pharmacists—are performing more functions. These include adjusting medication dosage, ensuring that patients receive tests and helping them to manage chronic diseases.”
Recently the New York Post reported “An Associated Press survey found examples coast to coast. Seattle Cancer Care Alliance is excluded by five out of eight insurers in Washington state’s insurance exchange. MD Anderson Cancer Center says it’s in less than half of the plans in the Houston area. Memorial Sloan-Kettering is included by two of nine insurers in New York City and has out-of-network agreements with two more”
“Doctors and administrators say they’re concerned. So are some state insurance regulators. In all, only four of 19 nationally recognized comprehensive cancer centers that responded to AP’s survey said patients have access through all the insurance companies in their state exchange”.
Family medicine is a model of care that focuses on caring for patients of all ages throughout their lives, with an emphasis on understanding the whole person and the communities where they live. Today, family physicians are in high demand due to the increased awareness of the importance of primary care in realigning our health care system to support the triple aims of the Accountable Care Act (ACA); better health care for individuals, better health outcomes in the community, and lower health care costs.