Blue Choice Option

Posted by on Oct 16, 2013 in Insurance | 0 comments

Blue Choice Option

“It could force us out of business.” That’s what some doctors are now saying about the fact that Excellus Blue Cross Blue Shield may soon drop certain Medicaid patients. A week ago, Excellus announced, beginning in January, that it will no longer offer certain Medicaid plans. That includes 85,000 people in the Rochester area. It’s all because Excellus is already looking at $100 million in losses for 2013 and says it can’t afford that.

Local doctors say this is bad news for them. Patients who currently use the Blue Choice option for Medicaid will have to find another health care plan. Doctors say, under those new plans, they will not be reimbursed as much for their services. News10NBC spoke to a doctor who says about 20 percent of his patients have Medicaid through Excellus.

Dr. William Morehouse said, “If our patient transfer over to any of the other plans currently in town, our overall practice could stand to lose between five and ten of its income on an annual basis which is a substantial loss when you are an inner city practice that is already having a hard time making ends meet.”

Other doctors in the area have a much higher percent of Blue Choice Medicaid patients, some as high as 60 percent. It’s those patients who could feel the brunt of this. News10NBC sat down with Nancy Adams with the Monroe County Medical Society. She says doctors are worried about the people they care for. The first problem they see is with the transition. Patients may have less access to care because their current specialists may not be on their new healthcare plan’s network.

Doctors are also worried about the trickle down effect. Less reimbursement means less income. Some say they will have to close up shop all together. Others say they won’t be accepting new Medicaid patients. Nancy Adams, Monroe County Medical Society, said, “We’re already in short supply of adult primary care physicians and then when you throw into the mix that not all physicians may except these other health plans then it would make it even more difficult to find a physician.”

According to the Monroe County Medical Society, there is still a chance Excellus could work something out with New York State and continue to carry these plans. News10NBC will continue to follow this story and update you on any developments.

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