IMO if you weren't affected by the change in healthcare you don't have a stake in the outcome. My husband and I received the letter and we are both anxiously awaiting the survey and (hopefully) positive result.

I respectfully disagree. There are many who disagree with the outcome, but really don't understand why. Do you?

If you have paid attention to the posts by Golfing Eagles you should have learned quite a bit. If not, that will become a problem for you later. The survey won't solve anything IMHO.


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My wife and I were both recipients of "the letter". We were patients of TVHC from its inception when Medicare plus BCBS supplement were perfectly acceptable. Of course this letter was not an apology of any sort. They did nothing wrong in their, decision making, but if we found such decisions to be "disruptive" (our own personal decision), then they are very sorry about that. So it's all our own fault after all!
Ha! Apology not accepted.
As a retired physician myself, I am perfectly aware that docs must frequently make choices as to just which insurance plans they will or will not accept as payment for their services. In my experience, however it was extremely rare for a physician to choose to accept only ONE particular insurance plan and eliminate all others. I suppose in this particular case it was not the physicians themselves who made this decision to accept only the UHC medical advantage plan, but rather the corporation which employs all the primary care docs in The Villages Health Care system. Namely the developer himself (and his family) whom I am sure are reaping a healthy profit from United Health Care on account of this arrangement.
The letter states "Our goal is to enhance health care services and improve health outcomes for everyone..." BS. Their goal is to maximize profits for themselves.

By the way, the attitude of theposter who incessantly insists no one was booted out, it was all our own choice reminds me of an old joke we anesthesiologist used to tell among ourselves concerning surgeons.
It goes like this:
What's the difference between God and a Surgeon???
Answer...
Well God realizes that He's not a Surgeon!

The Villages Heath - Survey
 

I disagree with you. I believe the decision was made by the practice leadership who are also physicians, but have a well founded understanding of the economics of their decision.

Most likely the developer will benefit by their decision, but he is also intelligent enough to delegate the decision to those who are able to understand how to make appropriate judgements. He is not doing well because he makes decisions from a lack of knowledge or support.

To your BS, I say the practice must certainly make decisions that allow it to survive. And I must ask, how was your practice doing when you retired? If you don't understand what the practice did here, and why, my guess is that you were not doing well. Or were you an employee of the practice and not involved in decision making?

Finally, you need to quit blaming the developer for decisions you don't care for, or fail to understand.

Alright, GE, what do you think?



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My practice did well enough to allow me to completely retire from medicine at the age of of 55, but thanks for your concern. I am now 74, by the way, and spent the last several years of my career as president of our 12 person anesthesia group.

A good part of my decision to retire involved insurance companies and other non medical entities trying to tell me how I should treat my patients, pharmacies telling me which drugs were "acceptable" and which weren't (based primarily on cost, of course), and hospitals telling me which surgeons I needed to work with and when.

Thank goodness I do not have to work in today's environment

And I don't particularly care what GE thinks.

The Villages Heath - Survey
 

I concur that i'm pleased not to have to work in today's environment.

In my last position I was responsible for 15 hospitals, and a few dozen owned practices. I can guarantee you that I was one of those telling contracted practices (radiology, anesthesiology, emergency medicine, etc.) what my expectations were.

You were what I called a hospital based practice. If you didn't like the terms of the contract you knew the consequences.

I'll let GE speak for himself, but I suspect you know well where I stand.


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[QUOTE=dbussone;1424670]I concur that i'm pleased not to have to work in today's environment.

In my last position I was responsible for 15 hospitals, and a few dozen owned practices. I can guarantee you that I was one of those telling contracted practices (radiology, anesthesiology, emergency medicine, etc.) what my expectations were.

You were what I called a hospital based practice. If you didn't like the terms of the contract you knew the consequences.

I'll let GE speak for himself, but I suspect you know well where I stand.

Oh, and PS, you should know better than blaming the developer by now. If it's not the developer it's the insurance companies or the hospitals, or something else.

I'm pleased you were able to retire successfully but you really need to learn to enjoy yourself


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Back to the letter. What is it that they want ? Some of the posters have assured us it is not to kiss and make up. They have also told us the only motivation driving the Village Health principals is associated with maximizing the economic benefits of their business model and generating profits. What could those former patients who elected to exit their business model because they did not want to buy the only acceptable insurance plan possibly tell them which would allow them to achieve additional economic benefit ?

I think someone told me the specialty practice they have been significantly beefing up will accept insurance plans other then the Advantage Plan they insist everyone purchase to access their primary practice. I might be incorrect about that, but speculate the referrals from the Village Health primary side might not be as many as needed to provide the economic support required to build the specialty practice. Deja' vu all over again ??? Hooray, they might take me back if I need a Urologist, at least until they achieve sufficient volume to again give me " the boot ". Such an action on the Village Health's part certainly would be justified acknowledging the economic reality of modern medicine as explained in depth in this post and others by many individuals.

Nah, that couldn't be their motivation. My imagination is just running away with me.

I think you may be on to something. The deed was done. Why stir the pot?

Your theory is speculation but why would TVHS get former patients who have moved on riled up again? Let sleeping dogs lie.

Why would they spend time and money and risk additional negative optics (justified or not--not the topic here) for this Survey for no good reason? Doesn't make sense.

The speciality practice already accepts other health plans including traditional Medicare. That didn't change when TVH switched to MA only for primary care physicians.

From the TVH Speciality Care web page:

SPECIALTY CARE ACCEPTED INSURANCE:

The Villages Health Specialty Care accepts Medicare and Medicare Supplemental policies in addition to accepting all the plans listed above in Primary Care Accepted Insurance.

Well said. :clap2: I get tired of people bashing the Villages for decisions made regarding The Villages Health. This was a business decision.
Everyone is in business to make money. Lots of people, care centers, supplies, utilities, etc. to take care of.
The Villages / Morse family don't owe us anything. They do a great job of providing us what we need. We then make the decisions.

Completely agree. However, the insurance decision is not the topic of this thread. Neither is the developer.

The thread's topic is the recent letter and the survey. The Mod came on and reinforced this.

A rehash of the issue of the old decision may be very valuable for some. Perhaps a new thread on that topic should be started for those interested in a trip down memory lane. Let's stay on topic.

Yes, I realize that, however, most of the posts are about insurance or refer to insurance.
I'm not "rehashing" just making a comment as I read all of the comments relating to insurance.
I'm sure the moderator will delete me if he/she wants.

There is actually a very practical reason why the specialty practice accepts more insurance carriers. It takes more primary care docs (and their patients) to support specialists. In other words, the specialty docs need referrals from physicians who are not in The Villages Health to make their practice financially successful.

A good business decision pure and simple.


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What do they want from their former patients ? That's the crux of the matter. Have some refused to see The Village Health specialists when referred by primary doctors not associated with The Village Health. Have some of those former patients told those other doctors they want nothing further to do with The Villages Health and why ? If so, might the other physicians be reluctant to refer anyone to The Villages Health specialists ?

The Villages Health principals want something, that is obvious. Apologies are expressions of regret generally offered for wrongs including unjust, dishonest or immoral acts, if I can still read a dictionary correctly. ( No doubt we will soon be debating the meaning of " is " ) Other posters have convinced me any action undertaken by The Villages Health must involve pecuniary gain. What in the world might it be they hope to gain from the survey results ?

Remember Paul Harvey
 

Pauls final words of his commentaries ...

"Now you know the rest of the story"

(To be continued, after the survey....if they release)

Bingo! These are the big unanswered questions, which is why I described the letter as vague.

And you're right, an apology is an apology.

Any way you slice it, this is an interesting, if mysterious, development.

The survey and hiring of the outside firm is indicative of some underling problem. A consideration to keep in mind is the change to Medicare plan C from plan A & B only impacts people over 65. The Medicare law has not changed. With few exceptions, all people in the US 65 and older are covered by one of the Medicare plans. The Villages is a 55+ community with many owners actually less than 55. These people with their insurance are still accepted by TVH. In fact, the average age of TV is around 67. So almost half are not on Medicare and can be treated with their current insurance. Yes, when you hit 65, you have to make choices on which Medicare options your going to take. But to have a system say I will only take one of the two sounds out of step.
I would guess the reason for the letter and the survey has more to do with the actual growth of the 65+ patients compared with the growth expected for the decision to make financial sense. With the growth in TV, the competition in the medical services field has to be huge. They have to have the infrastructure to provide the service, but they need to have the patient numbers grow to make it successful. These are the kind of things that can change decisions.

I agree, many of their underlings are a problem:1rotfl::1rotfl::1rotfl:
However, there may not be an underlying problem, they may simply be looking for information

Never go Back
 

Ok Where to start? I got the letter and so did my wife. This whole mess started when a friend of mind that I used to work with moved down here. Having the same Insurance as me (Top of the line BC & BS) asked me what Doctors I used. I recommended, “Village Health Care”. A few days later he came back to me saying they would not take him. Wondering what was going on I went to the center near me to find out. I met with the person in charge. When I asked what was going on, how come my friend could not get in I was told that they were only taking new patience’s with United Health Care. The person tried for about 10 minutes to get me to drop my BC&BS and join United. I said to her, “My wife has had 14 major operations and I have never seen a bill why should I change” Finally the person gave up. I was then told that it would NOT affect me I was grandfathered in. Out of curiosity I asked why they were doing this. I was told that the Doctors requested it so they could be paid easier. My response was OH???? I was under the impression that the Doctors worked for you and you paid them. I got no response she walked away. Then the bomb shell hit I was kicked out, BUT I was told that if I had “TriCare for Life” I could stay I would be grandfathered. (I do but they did not know that) There is no way that I would trust them. They are out for themselves not the individual. I am looking forward to the survey and so is my wife. Shame because we both liked who we were seeing. Our new Doctors are good.

I'm interested to read how many people seem to be anxious to turn to TVHS after they've made the choice to leave (or "have been booted out", as they like to see.

My wife and I were both in TVHS and left. We both loved our primaries and it was an extremely difficult decision for us to go (although fortunately we have found another wonderful primary outside TVHS). I would not go back to TVHS, however, and it's not because it wasn't a wonderful system. It's because they've already demonstrated that they have the right, and will exercise the right, to change the rules at any time without warning regardless of the consequences to their patients. What's to keep them from changing their minds again and shutting the whole system down? And if you're in TVHS system and they shut it down, where are you going to go for a primary when tens of thousands of people are facing the problem the same time you are?

A major factor in satisfactory health care is trust. They earned that when they gathered together a group of primary physicians that I think most people have found to be uniformly excellent--but then they threw that all away with the curveball last year. I, for one, am out of the system for good. I could never trust TVHS again.

People forget that they still take outside insurance for those under 65. I was with Bellevue Family Physicians long before they became the villages health. I will be told to leave if I choose a different medicare supplement plan when I turn 65. They accept most plans for those under 65. They are not a Villagers exclusive practice. As I am now 62 and have had my primary Dr. For 16 years. I hope they change their policy regarding outside insurance.

The decision to only accept UHC insurance is a greed based decision. Many patients left the villages health care system for good reasons, so many in fact that VHCS is looking to save face.
Some folks stated in this thread that we had a choice, stay and change insurance or leave. In my case my e-wife is insured by me and spends a great deal of time in Massachusetts, not possible for us. When I came to TV I rented for a year to give myself time to "check it out". I was impressed with the VHCS and my Doctor. There were many other things that I liked and some I didn't. The health care system was a big plus. So I purchased a home, then the health care system changed their insurance. Why?

OhioBuckeye
 

I lost all respect for TVH when we first moved here 6 yrs. ago I just had a 5 way heart bypass in Ohio where I lived. It was only 6 weeks afterward that I had an issue in my mouth due to breathing tubes during my heart surgery. I was told never be around people that had any kind of viruses. When I went to the waiting room I sat in there for 5 1/2 hrs. with 3 people having puke buckets for severe cases of the flu. I told the them about it & they said they couldn't do anything about it. (that was their exact words) Then when I did see someone it was a PA & he said I had a cold sore, wrong. We got into see the CEO of the hospital & told her the lot longer story, my $4,000+ dollar bill was forgiven. So Tampa can improve them all they want but if want good health care go somewhere else. Besides TVH can't do anything to your heart, all they can do is stabilize you & send you to another hospital, if you can make it!

I would be happy if they let me back in. I use the specialty group. But on July 1 got the boot for PCP. Not looking forward to finding another. Especially since they want you to use their specialist cohorts. Unfortunately it is about money and that is why our health care system is broken.

Interesting opinion, considering they do over 5,000 cardiac catheterizations/year most with stent placement.

TOTV's format has a quirk. You can edit a post, but you cannot edit a thread title. A typo in a title can hang there forever. I don't know if a moderator can fix a title typo or if it has to be an admin. The OP can't fix it.

Please! Somebody, please fix the title of this thread.

A heath is an open area of uncultivated land with characteristic vegetation of heather and coarse grasses and overgrown with shrubs -- especially in Britain.

Yes, TV certainly is buying up land, but I think they are concentrating on just our continent, for now. And besides, TV would never do a survey asking if we think they should buy more land.

Can't wait for the survey. I will be honest...........like where I told them to put their practice when they booted me. Now I have Michael Glick MD for my primary and do not intend to change. I sincerely hope they close up their fancy buildings and make more recreation centers out of them. LOL! MR

Here we go again. Must be the heat. Nobody "booted" you, you made a CHOICE, and "booted" yourself.

:a20:

I had DBS (Deep Brain Stimulation) done at Shands for essential tremor by Dr. Kelly Foote who is one of the worlds best at this type of surgery. The insurer may approve going out of network but Shands will not accept the Advantage Plan. I wouldn't have trusted this brain surgery to anyone but him.

Booted you out, you mean you left, so now you want VH to close down? ReallY?

First of all, if the insurer approves going out of network, it doesn't matter that Shands doesn't accept UHC MA---that's why they are out of network in the first place---the insurer pays them their usual fee or makes some sort of compromise arrangement.

Second, this is a rather unique treatment that is not available just anywhere---the odds are that the out of network referral would be approved. The only time that it wouldn't be is if there are many specialists in network who do the same procedure and you just WANT this particular doctor/hospital. And even then, in my experience, one phone call from your PCP to the medical director at UHC will get the approval.

Are you STILL ROFLYAO????????

That should help the resale value of your house. What were you thinking???

Best guess----he wasn't

When we moved to the Villages a year ago, one big reason was the proximity of good health care. Coming from Maui where health care is closer to a 3rd world country, we were hoping to find a good PCP. Then we learned that in order to use TVHC, we would need to buy a UHC supplemental. We are both covered by Medicare AND State of Michigan retiree BCBS supplemental. That insurance is a retirement benefit, covers medical expenses world wide, and costs us nothing. It is a superior plan to UHC, IMO, and we have never had a practitioner or facility not accept it. My hope is that the "powers that be" are potentially rethinking the UHC only decision. What intrigues me is the sentence in the letter that states " improving health care and outcomes for ALL Villages residents". Time will tell.

Shands WILL NOT accept the Advantage plan even with the out of network approval or compromise arrangement. No different than the Villages not accepting my supplemental plan.

And yes, I'm still :a20:

i have an excellent medicare supplement provided by my employer. As we all know, The Villages health decided that they would only accept that supplemental plan for those under 65.

Technically I made the choice to leave, however it really was a forced choice.

Think of the old Westerns, get out of town now or we shoot you. I guess leaving town is a choice you might make. :)

Was I writing in a language other than English? Shands will NOT accept UHC MA. The do not participate in it, if they did they would NOT be out of network!!! And "out of network approval" has nothing to do with Shands, it is a decision made by the insurer as to whether or not they will pay them their asking price or reimburse you. What you are saying is that a patient can show up at Shands, no insurance, but with a boatload of cash , and they won't see him. Unlikely.
Perhaps DB has some insight on how this works from a hospital administrator's point of view.

Absolutely, and it most likely was the right CHOICE for your situation. Other people made other CHOICES that were right for their situations. My only argument is with those who insist they had NO CHOICE, or that they were "booted".

You made this choice for financial reasons, you did not want to give up a benefit worth thousands. Would you have left if it cost you $10??? $100? $1000? Basically there is a price point for those who left for financial reasons. And that point is different for you and I than it is for Bill Gates or Warren Buffet. Only you can decide what is right for you.