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24% of US Doctors Have Opted Out of Obamacare Exchanges

Tug Boat BobTug Boat Bob Posts: 2,570 Captain
Over 214,000 Doctors Opt Out of Obamacare Exchanges


October 28, 2014 - 11:28 AMBarbara%20Boland7585_0.jpg
By Barbara Boland

Over 214,000 doctors won't participate in the new plans under the Affordable Care Act (ACA,) analysis of a new survey by Medical Group Management Association shows. That number of 214,524, estimated by American Action Forum, is through May 2014, but appears to be growing due to plans that force doctors to take on burdensome costs. It's also about a quarter of the total number of 893,851 active professional physicians reported by the Kaiser Family Foundation.

In January, an estimated 70% of California's physicians were not participating in Covred California plans.

Here are some of the reasons why:

1. Reimbursements under Obamacare are at bottom-dollar - they are even lower than Medicare reimbursements, which are already significantly below market rates. "It is estimated that where private plans pay $1.00 for a service, Medicare pays $0.80, and ACA exchange plans are now paying about $0.60," a study by the think-tank American Action Forum finds. "For example, Covered California plans are setting their plan fee schedules in line with that of Medi-Cal-California's Medicaid Program-which means exchange plans are cutting provider reimbursement by up to 40 percent."

2. Doctors are expected to take on more patients to make up for the lost revenue, but that's not happening, because primary care doctors already have more patients than they can handle. "Furthermore, physicians are worried that exchange plan patients will be sicker than the average patient because they may have been without insurance for extended periods of time, and therefore will require more of the PCPs time at lower pay," says the study.

The study also points to two reasons that doctors might not get paid at all:

3. An MGMA study indicates that 75% of ACA patients that had seen doctors had chosen plans with high deductibles. Given that most of the patients are low-income, doctors are concerned that the patients cannot meet the deductibles and they will get stuck with the bill.

4. HHS requires that insurers cover customers for an additional 90 days after they have stopped paying their premiums: the insurer covers the first 30 - but, it's up to the doctor to recoup payment for the last 60 days. This is the number one reason providers are opting to not participate in the exchange plans. Currently, about a million people have failed to pay their premiums and had their plans canceled.

So, Obamacare is asking doctors to take on sicker patients for less money, with the risk of not getting paid at all? No wonder doctors are running from these plans!

http://cnsnews.com/mrctv-blog/barbara-boland/over-214000-doctors-opt-out-obamacare-exchanges

Total Professionally Active Physicians




[TH="class: sorted"]Location[/TH]
[TH]Primary Care Physicians[/TH]
[TH]Specialist Physicians[/TH]
[TH]Total Physicians[/TH]


United States
425,032
468,819
893,851


Alabama
5,251
5,684
10,935


Alaska
920
790
1,710


Arizona
7,829
8,452
16,281


Arkansas
3,177
3,339
6,516


California
48,472
52,760
101,232


Colorado
6,546
6,752
13,298


Connecticut
6,061
7,642
13,703


Delaware
1,329
1,486
2,815


District of Columbia
2,685
3,466
6,151


Florida
24,172
25,859
50,031


Georgia
11,201
11,512
22,713


Hawaii
1,764
1,881
3,645


Idaho
1,477
1,367
2,844


Illinois
19,321
19,076
38,397


Indiana
7,528
8,126
15,654


Iowa
3,920
3,565
7,485


Kansas
3,523
3,252
6,775


Kentucky
4,958
5,799
10,757


Louisiana
5,553
6,582
12,135


Maine
2,207
2,117
4,324


Maryland
9,886
12,187
22,073


Massachusetts
13,971
17,392
31,363


Michigan
16,214
17,962
34,176


Minnesota
7,795
8,374
16,169


Mississippi
2,963
3,024
5,987


Missouri
8,603
9,712
18,315


Montana
1,033
1,109
2,142


Nebraska
2,513
2,367
4,880


Nevada
2,721
2,753
5,474


New Hampshire
1,830
2,011
3,841


New Jersey
12,856
14,070
26,926


New Mexico
2,546
2,529
5,075


New York
34,578
42,754
77,332


North Carolina
11,707
12,769
24,476


North Dakota
957
822
1,779


Ohio
17,216
20,181
37,397


Oklahoma
4,248
4,249
8,497


Oregon
5,291
5,599
10,890


Pennsylvania
21,066
24,101
45,167


Rhode Island
2,154
2,254
4,408


South Carolina
5,677
5,617
11,294


South Dakota
953
901
1,854


Tennessee
8,167
9,302
17,469


Texas
27,615
30,200
57,815


Utah
2,701
3,352
6,053


Vermont
1,035
1,080
2,115


Virginia
10,568
11,223
21,791


Washington
9,530
10,068
19,598


West Virginia
2,533
2,520
5,053


Wisconsin
7,630
8,293
15,923


Wyoming
581
537
1,118



http://kff.org/other/state-indicator/total-active-physicians/
"Great lives never go out, they go on."
Benjamin Harrison 1833-1901
23rd President of the United States, 1889-1893
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Replies

  • FreeLinerFreeLiner Posts: 1,573 Captain
    The biggest and not discussed topic on docs opting out are those who no longer are accepting new Medicare patients.

    Also a lie that Obama is not being held to. The "Obamacare wont effect grandma and grandpas Medicare" lie.
  • Mister-JrMister-Jr Posts: 27,700 AG
    Proof that some peeps will believe anything (and post it here).
    Vote for the other candidate
  • Tug Boat BobTug Boat Bob Posts: 2,570 Captain
    Mister-Jr wrote: »
    Proof that some peeps will believe anything (and post it here).

    OK peeps Jr. what part of the OP don't you believe? And please, post it here. TYIA

    Or were you just making noise to up your post count as usual?
    "Great lives never go out, they go on."
    Benjamin Harrison 1833-1901
    23rd President of the United States, 1889-1893
  • Mister-JrMister-Jr Posts: 27,700 AG
    OK peeps Jr. what part of the OP don't you believe? And please, post it here. TYIA

    Or were you just making noise to up your post count as usual?
    It's a bunch of cobbled together info that means nothing. The CNS authors take statements from various sources and linked them together to try and make the reader believer something that is false.

    In January, an estimated 70% of California's physicians were not participating in Covred California plans.

    What does that have to do with anything? The ACA didn't become law until January.
    Vote for the other candidate
  • Tug Boat BobTug Boat Bob Posts: 2,570 Captain
    Mister-Jr wrote: »
    Proof that some peeps will believe anything (and post it here).
    OK peeps Jr. what part of the OP don't you believe? And please, post it here. TYIA

    Or were you just making noise to up your post count as usual?
    Mister-Jr wrote: »
    It's a bunch of cobbled together info that means nothing. The CNS authors take statements from various sources and linked them together to try and make the reader believer something that is false.

    In January, an estimated 70% of California's physicians were not participating in Covered California plans.

    What does that have to do with anything? The ACA didn't become law until January.
    Wrong again Jr.

    The Affordable Care Act (ACA) became law on March 23, 2010. The implementation of the law is happening over a number of years as different aspects of it become law. Full implementation will be completed in 2015.

    Did You Know?

    In 2010, California was the first state in the nation to enact legislation to implement the provisions of the federal Affordable Care Act by creating a health care marketplace — Covered California.

    Again, what part of the "cobbled" OP is false?
    "Great lives never go out, they go on."
    Benjamin Harrison 1833-1901
    23rd President of the United States, 1889-1893
  • shadowwalkershadowwalker Posts: 2,200 Captain
    Can't wait to see how the Liberals are going to try and put doctors into pressed service. That should raise the quality of heath care don't ya know.
  • rickcrickc Posts: 9,172 Admiral
    Could be American doctors are overpaid and need to do like the rest of us and tighten up the belt buckle

    I will be glad when the health insurance companies price themselves completely out of the market and we go back to the public option. Medicare for everyone.

    GPpay.jpg
  • CatBoxCatBox Posts: 3,709 Captain
    rickc wrote: »
    Could be American doctors are overpaid and need to do like the rest of us and tighten up the belt buckle

    Oh my GAWD, are you REALLY blaming the Doctors being greedy???? :Spittingcoffee

    I would say that going to College for 10 years (along with huge student loans) and residency for a few more years, only to make an average of $160k is an extremely poor ROI.

    Sure glad that I went the Computer route back in College.

    Pathetic class warfare at it's best, jealousy or envy at it's worse :blahblah
  • Holmes BeachHolmes Beach Posts: 969 Officer
    Mister-Jr wrote: »
    It's estimated 70% of California's physicians were not participating with The ACA law

    I'm glad you agree that doctors should not accept a meager payout for your Savior's only successful legislative and financial attack on the American people.
  • shadowwalkershadowwalker Posts: 2,200 Captain
    rickc wrote: »
    Could be American doctors are overpaid and need to do like the rest of us and tighten up the belt buckle

    I will be glad when the health insurance companies price themselves completely out of the market and we go back to the public option. Medicare for everyone.

    GPpay.jpg
    Ever lived in of those other country's out side the U.S.A. Your graph doesn't mean much.
  • Mister-JrMister-Jr Posts: 27,700 AG
    Wrong again Jr.

    The Affordable Care Act (ACA) became law on March 23, 2010. The implementation of the law is happening over a number of years as different aspects of it become law. Full implementation will be completed in 2015.

    Did You Know?

    In 2010, California was the first state in the nation to enact legislation to implement the provisions of the federal Affordable Care Act by creating a health care marketplace — Covered California.

    Again, what part of the "cobbled" OP is false?

    Health insurance was not required until 01/01/2014, making the rest of your copy and paste worthless. You might as well get over it, it's the law, has worked fairly well and is not going away. Or you can continue to live in the past and ride your horse every place you go.
    Vote for the other candidate
  • Mister-JrMister-Jr Posts: 27,700 AG
    I'm glad you agree that doctors should not accept a meager payout for your Savior's only successful legislative and financial attack on the American people.

    Boo f'n hoo
    Vote for the other candidate
  • NewberryJeffNewberryJeff Posts: 7,447 Admiral
    The corporate handout is working fairly well.
    The promised reduced premiums and increased access to care, not so much.
    Wait until many of those people who received advanced tax credits for their premiums find out they get a smaller return or they have a balance due.
    RIP Obamacare.
  • White DogWhite Dog Posts: 5,343 Officer
    160K doesn't seem unreasonable to me when you consider the schooling and skill level.
    The White Dog.........R.I.P..........1996 - June 2nd, 2011
  • rickcrickc Posts: 9,172 Admiral
    Doctor Pay Rises To $221K For Primary Care, $396K For Specialists


    http://www.forbes.com/sites/brucejapsen/2013/06/12/doctor-pay-rises-to-221k-for-primary-care-396k-for-specialists/


    One of the reasons health care is so much more expensive in America. the table below shows why so many American's can't afford health care.

    us-household-income.png

    http://www.mybudget360.com/how-much-do-americans-earn-what-is-the-average-us-income/
  • LuckyMrSwLuckyMrSw Posts: 3,208 Captain
    Or call greggl and his people, they can do anything and everything without an education or degrees. Just ask him
    White Dog wrote: »
    160K doesn't seem unreasonable to me when you consider the schooling and skill level.
    Please stop derailing my thread.
    `Forum Moderator`

    Don't call each other names
    `Same Forum Moderator`
  • NewberryJeffNewberryJeff Posts: 7,447 Admiral
    rickc wrote: »
    Doctor Pay Rises To $221K For Primary Care, $396K For Specialists


    http://www.forbes.com/sites/brucejapsen/2013/06/12/doctor-pay-rises-to-221k-for-primary-care-396k-for-specialists/


    One of the reasons health care is so much more expensive in America. the table below shows why so many American's can't afford health care.

    [IMGhttp://www.mybudget360.com/wp-content/uploads/2008/12/us-household-income.png[/IMG]

    http://www.mybudget360.com/how-much-do-americans-earn-what-is-the-average-us-income/


    More losers should go to medical school and even out the income level.
  • Tug Boat BobTug Boat Bob Posts: 2,570 Captain
    Mister-Jr wrote: »
    Health insurance was not required until 01/01/2014, making the rest of your copy and paste worthless. You might as well get over it, it's the law, has worked fairly well and is not going away. Or you can continue to live in the past and ride your horse every place you go.

    Still no answers?

    And your last sentence has nothing to do with the subject at hand. I'm not suggesting or implying that the ACA be repealed. I'm just pointing out a major problem that will probably grow worst over time.

    So again, what part of 24% of US Doctors opting out of Obamacare exchanges is worthless and you still think that all is going fairly well?
    70% of CA physicians having opted out of "Covered California" since 2010 is also not a problem and isn't indicative of what's to come?

    Answer these 2 questions if you can. It'll also raise your post count.
    "Great lives never go out, they go on."
    Benjamin Harrison 1833-1901
    23rd President of the United States, 1889-1893
  • CatBoxCatBox Posts: 3,709 Captain
    Now that RWNJ news outlet Reuters is understanding the impact of the smartest president ever signature legislation... :rotflmao

    http://news.yahoo.com/less-half-doctors-insurance-directories-may-available-212320337.html

    Less than half of doctors in insurance directories may be available
    Reuters By Andrew M. Seaman
    18 hours ago

    By Andrew M. Seaman

    (Reuters Health) - More than half the dermatologists in Medicare Advantage plan directories were either dead, retired, not accepting new patients or specialized only in specific conditions, researchers found when they tried making appointments.

    Inaccurate directories of doctors covered by an insurance plan may lead to people having very few options and to the U.S. government approving plans that don’t meet standards regarding provider availability, the study team writes in JAMA Dermatology.

    “I think it just identifies a big area that needs a lot of help to increase transparency to patients,” said Dr. Jack Resneck, Jr. from the University of California, San Francisco, the study’s lead author.

    The U.S. requires private insurance plans offered through Medicare (the government-run insurance program for the elderly and disabled) and through exchanges set up by the Affordable Care Act to offer plan participants a variety of doctors.

    Even so, insurers have been increasingly "narrowing" their networks by eliminating contracts with physicians, the researchers write.

    They add that there is increasing attention toward the limited choices offered to patients through the private plans in Medicare - known as Medicare Advantage - and the Affordable Care Act.

    For the new study, Resneck and his colleagues analyzed the accuracy of the lists of dermatologists that insurance companies said accepted Medicare Advantage plans.

    The directories, from 12 U.S. metropolitan areas, included the names of 4,754 dermatologists. About 46 percent of those doctors were listed twice, however.

    The researchers then attempted to make appointments with dermatologists, for a fictional father who had an itch for months and was about to select a Medicare Advantage plan.

    Of the remaining 2,590 dermatologists listed in the directories, about 18 percent were not reachable, about 9 percent had retired, died or moved and another 9 percent were not accepting new patients.

    Overall, only 1,266 dermatologists – or less than half – were reachable, accepted the specific Medicare Advantage plan and offered an appointment.

    For one of the plans, the researchers were not able to make an appointment with any of the listed dermatologists.

    What’s more, the average time the fictitious patients had to wait for an appointment was about 46 days.

    Resneck said different plans in different geographic areas varied in the accuracy of their directories.

    “Across the board, nobody scored that well here,” he said. “I thought because of the attention that had been paid to this, I thought insurers would have paid some attention to cleaning up these directories.”

    The researchers note that they can’t tell whether the inaccurate directories are misleading federal regulators, because they weren’t able to access the reports that health plans submit to the government.

    They also don't know if the results would be similar for other medical specialties.

    “We can’t say for sure, but I see no reason why insurance companies would have a particularly difficult time keeping their dermatology directories up to date,” Resneck said.

    Earlier this month, a study found many errors in insurance directories of psychiatrists (see Reuters Health story of October 17, 2014 here: http://reut.rs/1039tdK).

    "Medicare Advantage plans do provide a wide range of providers and specialists to meet beneficiaries’ diverse health needs," said Clare Krusing, director of communications for America's Health Insurance Plans, which is the national trade association representing the insurance industry.

    "There is a shared responsibility between providers and health plans to ensure seniors have access to the care and resources they need when it comes to their health care choices," Krusing added in her email to Reuters Health. "Greater transparency on the part of those specialists participating in provider networks is critical to making this happen."

    Resneck said insurance companies should “hit the pause button” before removing any more providers from their insurance plans.

    “Taking more and more physicians out of an insurance network when there is already a long wait can only make that worse,” he said.

    SOURCE: http://bit.ly/10z87bK JAMA Dermatology, online October 29, 2014.
  • rickcrickc Posts: 9,172 Admiral
    Still no answers?

    And your last sentence has nothing to do with the subject at hand. I'm not suggesting or implying that the ACA be repealed. I'm just pointing out a major problem that will probably grow worst over time.

    So again, what part of 24% of US Doctors opting out of Obamacare exchanges is worthless and you still think that all is going fairly well?
    70% of CA physicians having opted out of "Covered California" since 2010 is also not a problem and isn't indicative of what's to come?

    Answer these 2 questions if you can. It'll also raise your post count.


    Well its a free country. If they can make it without ACA so be it. I believe the percentages are about the same as to the doctors who opt out of medicare.

    Eventually though we will move to a single payer system. Only one game in town then. Medicare is a good model. Guess that 25% can still opt out and go with cash customers or who knows we may still have private insurance around for those who can afford it.
  • FreeLinerFreeLiner Posts: 1,573 Captain
    The future for the Medicaid and lower/middle will be a single payer.

    Upper middle and beyond will be paid MVP docs.

    ACA is nothing more than a pay off to big insurance. Robbing us blind.
  • JBondJBond Posts: 5,039 Officer
    Mister-Jr wrote: »
    Health insurance was not required until 01/01/2014, making the rest of your copy and paste worthless. You might as well get over it, it's the law, has worked fairly well and is not going away. Or you can continue to live in the past and ride your horse every place you go.

    I thought you were against corporate welfare? Now you are for it. Odd.
  • FinfinderFinfinder Posts: 9,999 Admiral
    libs were told this was going to happen
  • mikevmikev Posts: 10,822 AG
    rickc wrote: »
    Doctor Pay Rises To $221K For Primary Care, $396K For Specialists

    Just curious, but if the one person that you love the most needed a specialist to perform some sort of surgery to saved your loved one, would you consider that doctor to be over paid?
    "The only people that tell you it can't be done are the people who haven't done it themselves."
  • SWFL_F1sh0nSWFL_F1sh0n Posts: 17,248 Officer
    SHouldn't this read that 76% of all doctors are in support of the ACA?
  • FinfinderFinfinder Posts: 9,999 Admiral
    rickc wrote: »
    Well its a free country. If they can make it without ACA so be it. I believe the percentages are about the same as to the doctors who opt out of medicare.

    Eventually though we will move to a single payer system. Only one game in town then. Medicare is a good model. Guess that 25% can still opt out and go with cash customers or who knows we may still have private insurance around for those who can afford it.

    only way you can move to a single payer system if the Democrats can get away with lying to the public again
  • FinfinderFinfinder Posts: 9,999 Admiral
    SHouldn't this read that 76% of all doctors are in support of the ACA?

    no
  • SWFL_F1sh0nSWFL_F1sh0n Posts: 17,248 Officer
    Finfinder wrote: »
    no

    If you read the article, that's exactly how the title should read.
  • TonySalTonySal Posts: 1,479 Officer
    i can name over 20 HMO programs that were present before Obamacare and are in current circulation with huge companies like Home Depot, Target, Kmart, Burger king and others, and of those 20, 50% of U.S doctors will not accept those HMO's, so whats your point? Educate yourself a tad on why specifically doctors do take certain plans and get back to me. Its has MUCH more to do than just reimbursement.
  • Big BatteryBig Battery Posts: 20,071 AG
    Yea...because that's a good comparison. Jeez.
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