[Mikeod]

The VHS system as originally configured was not sustainable. Long appointment times and limited panel size significantly reduced reimbursements under traditional medicare, even with supplements, which do not benefit the provider as much as the patient. As a result, the developer agreed to directly support the system for a period of time, which has expired. Also, using the reimbursement system makes it difficult to budget, since income will fluctuate, reimbursements be denied/appealed/delayed. Thus VHS is faced with the choice of closing, or increasing income/decreasing expenses. With MA plans, VHS will get guaranteed income per MA member and the ability to manage services/expenses with more certainty of funds. Would you rather they closed down? How would that have lessened the problem?

Why choose only one MA plan? Well, upon initiating the VHS, there was a connection between UHC and VHS that must have benefited both VHS and the developer. Perhaps that relationship had some limitations that precluded other MA plans being accepted by VHS.

Why is the Marcus Welby thing considered a lie? Those who have had VHS spoke highly of the time they had available with their doctor. And how a lot of services were available in house. I remember seeing my PCMD and told I needed to get labs and an X-ray done. Told to go over there for the labs, and over there for the X-ray. Then hope like crazy the results got back to him. Contrast that to those who needed those services within VHS and just walked down the corridor to get them done. When I was with VHS and needed an X-ray, I was walked to the X-ray, had it done, then back to the doctor's room and had him read it right there at the same visit. I think that is what has meant by the Marcus Welby comment.

Now, where I have difficulty with "the letter" is the place where they made it sound as if the prime motivator to the change was a concern for better outcomes. This was, as stated by many before me, a business decision. Improve revenue or close. It would have gone over better if they had owned up to the fact that they had hoped to keep all the members, but, if they wanted to continue the mode of practice (long appointment time, limited panels, in-house services, etc.), they had to improve revenue flow. Making it sound as if this was other than that certainly angered and frustrated many.