[Schneil]

We are so disappointed in the healthcare program and restrictions. The advertising which sold us on TV while house hunting was and continues to be misleading. I particularly love the following advertisement that "health care is just a short golf cart ride away...." There is no disclaimer of: "only if you belong to UHC! Shame on the Morse family!

Copied from the Village Website:

An important part of a great retirement lifestyle is convenient access to wellness facilities and quality health care.

The Villages Health and USF HEALTH, a major academic health resource, are partnering to make The Villages America's Healthiest Hometown.

Staying healthy is easy in The Villages. Neighborhood fitness centers and health care facilities are located throughout The Villages -- just a golf car ride away. The Villages Healthcare Centers, The Villages Regional Hospital, Moffitt Cancer Center, VA outpatient clinic, senior living facilities, and a long term acute care hospital are all located here.

[Challenger]

Originally Posted by Schneil

We are so disappointed in the healthcare program and restrictions. The advertising which sold us on TV while house hunting was and continues to be misleading. I particularly love the following advertisement that "health care is just a short golf cart ride away...." There is no disclaimer of: "only if you belong to UHC! Shame on the Morse family!

Copied from the Village Website:

An important part of a great retirement lifestyle is convenient access to wellness facilities and quality health care.

The Villages Health and USF HEALTH, a major academic health resource, are partnering to make The Villages America's Healthiest Hometown.

Staying healthy is easy in The Villages. Neighborhood fitness centers and health care facilities are located throughout The Villages -- just a golf car ride away. The Villages Healthcare Centers, The Villages Regional Hospital, Moffitt Cancer Center, VA outpatient clinic, senior living facilities, and a long term acute care hospital are all located here.

My wife and I have been here five years. Both in our late seventies with a need for multiple health professionals including dermatology ,urology, dentistry, cardiology , and others . Have never had a moments problem accessing health care sine we moved here.

[CT514s]

We have UHC (not their Medicare Advantage) plan as our supplemental and are part of Villages Health Care. Had a long wait for our initial appointments, but no problems since then.

[villages07]

Back to the OPs post...I believe the main issue is that Villages Health does not have enough doctors. Are their hiring standards too high or are they just having trouble recruiting into this new concept, or just not paying enough in salary? Each center supposedly could support 8 doctors. Last I looked, Creekside/Sumter only had 5. If they had more docs, they could take on more patients. Dr Eagles....do you have an opinion on this?

[golfing eagles]

Originally Posted by villages07

Back to the OPs post...I believe the main issue is that Villages Health does not have enough doctors. Are their hiring standards too high or are they just having trouble recruiting into this new concept, or just not paying enough in salary? Each center supposedly could support 8 doctors. Last I looked, Creekside/Sumter only had 5. If they had more docs, they could take on more patients. Dr Eagles....do you have an opinion on this?

Well, now that you mention it........

The first problem is national---The number of primary care doctors is shrinking rapidly. Currently there are a total of about 900,000 clinicians in the US, 624,000 are involved in direct patient care, and 209,000 are in primary care. Some estimates expect the total number to decrease by 250,000 in the next 5-7 years due to a variety of factors----early retirement, alternative careers , and medical careers that do not involve patient care.
Young physicians are trending towards specialty and sub-specialty care---as the technology develops and the body of knowledge expands exponentially, there is much more to know and new niches to fill. Primary care, in particular suffers because it is considered less "glamorous", overburdened by documentation and regulation, and to a certain degree is less lucrative.
As a result, recruiting is much more difficult all over. I don't know how the recruiting goes in TV Health---I believe they were originally aiming for 8 centers with 8 docs each, but they have taken a pause. I honestly don't know the reason but recruitment may be a part of it. Personally, I don't think hiring standards can ever be too high, but realism has to set in at some point. Yes, their goal is a fairly new concept, they want to build the best ACO possible, and this involves a lot of paperwork and regulation. This is why they try to limit patient profiles to 1250 patients/physician, have 1/2 hr follow up appts and 1 hr initial appts, which is about 1/2 of the national average.
I don't think salary is a huge factor. Those who are chasing dollars have already decided to go into specialty care, or avoid a medical career entirely and go to Wall Street--it's a lot easier to get a MBA than a MD. It appears the salaries offered at TV Health are about average for primary care, so they are competitive in their financial package.
I hope this answers some of your questions, IMHO.

[dbussone]

Originally Posted by golfing eagles

Well, now that you mention it........



The first problem is national---The number of primary care doctors is shrinking rapidly. Currently there are a total of about 900,000 clinicians in the US, 624,000 are involved in direct patient care, and 209,000 are in primary care. Some estimates expect the total number to decrease by 250,000 in the next 5-7 years due to a variety of factors----early retirement, alternative careers , and medical careers that do not involve patient care.

Young physicians are trending towards specialty and sub-specialty care---as the technology develops and the body of knowledge expands exponentially, there is much more to know and new niches to fill. Primary care, in particular suffers because it is considered less "glamorous", overburdened by documentation and regulation, and to a certain degree is less lucrative.

As a result, recruiting is much more difficult all over. I don't know how the recruiting goes in TV Health---I believe they were originally aiming for 8 centers with 8 docs each, but they have taken a pause. I honestly don't know the reason but recruitment may be a part of it. Personally, I don't think hiring standards can ever be too high, but realism has to set in at some point. Yes, their goal is a fairly new concept, they want to build the best ACO possible, and this involves a lot of paperwork and regulation. This is why they try to limit patient profiles to 1250 patients/physician, have 1/2 hr follow up appts and 1 hr initial appts, which is about 1/2 of the national average.

I don't think salary is a huge factor. Those who are chasing dollars have already decided to go into specialty care, or avoid a medical career entirely and go to Wall Street--it's a lot easier to get a MBA than a MD. It appears the salaries offered at TV Health are about average for primary care, so they are competitive in their financial package.

I hope this answers some of your questions, IMHO.

GE - I would add that the Feds also have a significant hand in this situation. Despite the fact that our country's population is growing, and the number of elderly is increasing, the Feds capped the number of residency positions in the late '90s. This is simply a matter of money. The Feds partially reimburse teaching hospitals for the cost of training physician so they capped the number of available slots to reduce future expenses. In essence there is an artificial choke point on the training of physicians regardless of current or future need IMO.

[golfing eagles]

Originally Posted by dbussone

GE - I would add that the Feds also have a significant hand in this situation. Despite the fact that our country's population is growing, and the number of elderly is increasing, the Feds capped the number of residency positions in the late '90s. This is simply a matter of money. The Feds partially reimburse teaching hospitals for the cost of training physician so they capped the number of available slots to reduce future expenses. In essence there is an artificial choke point on the training of physicians regardless of current or future need IMO.

The FEDS are a whole other chapter in this, but yes, they did cap residency support, but this was for specialty residencies while continuing to support primary care residencies. Of course, the flaw here was that 3 years of internal medicine is required prior to a specialty. They did change many specialty fellowships from 2 to 3 years, so the number of specialists finishing went down. I don't think there is much of a choke point---most residency programs cannot fill their slots with American graduates, hence the escalating need for patients to be "multi-lingual"
At the same time, IF Obamacare succeeds in bringing in 40 million new patients, the demand will be far greater

[NYGUY]

Before moving to The Villages, my PCP was the also the Chairman of the Department of Family Medicine at The University of South Florida. He always had students with him during office visits and we often discussed the difficulties of recruiting students to Family Medicine. He mentioned many of the same issues as GE has pointed out (compensation, practice costs, prestige, etc).

[dotti105]

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. WE are the ones who create the highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

[NYGUY]

Originally Posted by dotti105

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. WE are the ones who create the highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

You are absolutely correct!!!..
Another instance of the tail wagging the dog!!!

[golfing eagles]

Originally Posted by dotti105

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

WE are the ones who create the My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

I too favor a single payer system, but with the caveat that the government is barred from administering its own program, otherwise, cost will go UP
Administrative costs for private insurance run 11-13%, government program insurance runs about 32%---which just goes to prove what we all already know---1 private sector worker can do as much as 3 government workers.
There will be those that go online and see numbers like medicare has a 5% administrative cost, but this is a fallacy. Medicare gets gov't office space, paid for in a different budget. They don't have billing and collection costs--that's in the IRS budget. They don't have mailing cost, office equipment cost, phone cost---I think the GSO covers that. They operate across state lines, which private insurance cannot do. When you add it all up from the different budgets, it comes to about 32%
And according to a BNA study, “Popular comparisons of Medicare and private group health plan ‘overhead’ costs wrongly compare only a part of administrative expenses related to the Medicare program to the whole of private sector administrative expenses for comparable large group health plans.” The report also says that Medicare’s costs for claims administration “are really about the same as claims administration costs in the private large group health plan market.” Moreover, some of Medicare’s general administration costs are expensed elsewhere in the federal budget, and others, like premium taxes, do not apply to the Medicare program. - See more at: Fact Check on Administrative Costs | AHIP Coverage
Finally, the other downside: Your dad may have been correct about the insurance company "choke hold", but that would be traded in for a GOVERNMENT choke hold. I leave it to the reader to decide which is worse

[dbussone]

Originally Posted by golfing eagles

I too favor a single payer system, but with the caveat that the government is barred from administering its own program, otherwise, cost will go UP

Administrative costs for private insurance run 11-13%, government program insurance runs about 32%---which just goes to prove what we all already know---1 private sector worker can do as much as 3 government workers.

There will be those that go online and see numbers like medicare has a 5% administrative cost, but this is a fallacy. Medicare gets gov't office space, paid for in a different budget. They don't have billing and collection costs--that's in the IRS budget. They don't have mailing cost, office equipment cost, phone cost---I think the GSO covers that. They operate across state lines, which private insurance cannot do. When you add it all up from the different budgets, it comes to about 32%

And according to a BNA study, “Popular comparisons of Medicare and private group health plan ‘overhead’ costs wrongly compare only a part of administrative expenses related to the Medicare program to the whole of private sector administrative expenses for comparable large group health plans.” The report also says that Medicare’s costs for claims administration “are really about the same as claims administration costs in the private large group health plan market.” Moreover, some of Medicare’s general administration costs are expensed elsewhere in the federal budget, and others, like premium taxes, do not apply to the Medicare program. - See more at: Fact Check on Administrative Costs | AHIP Coverage

Finally, the other downside: Your dad may have been correct about the insurance company "choke hold", but that would be traded in for a GOVERNMENT choke hold. I leave it to the reader to decide which is worse

If you want to know how the government runs things, just remember that the FDA allows up to 10% miscellaneous "material" in your hot dog. Think of ObamaCare as the same sort of production process.

[golfing eagles]

Originally Posted by dbussone

If you want to know how the government runs things, just remember that the FDA allows up to 10% miscellaneous "material" in your hot dog. Think of ObamaCare as the same sort of production process.

I hope they re-define that "10% miscellaneous" in light of terrorist attempts to acquire nuclear material!!!

[Avista]

Originally Posted by dotti105

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. WE are the ones who create the highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

Well said, Dotti!

[goodtimesintv]

Originally Posted by dotti105

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. WE are the ones who create the highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

The ACA and the feds have given more power and market share to the biggest insurers and United Healthcare-AARP than they have ever had!!

"These Medicare supplement insurance companies are the biggest of all the companies and most of them have been around the longest.

AARP– AARP is the largest and most recognized company for senior insurance. They are in every state and at the top of the food chain for all the Medicare supplement insurance companies. Find out more about an AARP Medicare supplement HERE.

Mutual of Omaha– Second only to AARP Mutual of Omaha is one of the most respected insurance companies in the U.S. They have made a big push to be a major competitor in the Medicare supplement market. Get more information on a Mutual of Omaha Medicare supplement HERE.

Humana – By forming a relationship with Wal-Mart for Medicare Part D, Humana has catapulted itself into a bigger part of the medigap market. Learn more about a Humana Medicare supplement HERE.

Gerber– Gerber made a huge splash when they entered the Medicare supplement market and moved quickly from the new guy to a major competitor. Get more information on a Gerber Medicare supplement HERE."

Medicare Supplement Insurance Companies - View Rates Online