Originally Posted by rockyisle (Post 1232218)

Well, here's what I know from someone "in the know". This person was a member of the focus group that met this Spring to discuss the next round of changes to VHS and the possible impact and reaction of those of us who joined the program 3 years ago. Our primary care doctor has confirmed that current plans mean we will be out on January 1st if we don't move over to the VHS HMO plan.



I'm in the process of writing a letter to Jeffrey Lowenkron at the VHS (he's their Chief Medical Officer) protesting this latest move. So much for the Doctor Welby approach to medicine that was advertised by VHS. For whatever reason, it appears that they are not making money on their grand plan - or not making enough money. What I do know is that they have created a program with United Healthcare - much like AARP - that will pay them royalties for everyone who moves over to this new program. The rest of their financial plans are a mystery to me.



So, with that said... I will be very sad to leave VHS as I came over with my doctors from Family Doctors of Belleview (which no longer exists as a private care practice)... It's now part of the VHS system. VHS was very convenient for us and we felt we received great medical care. We will be looking for another primary care doctor who is willing to take the Medicare and United Healthcare Plan F reimbursements.



The curious part of all this (for me) is wondering how they think they will make money on any program only funded through Medicare and out of pocket payments by those who get sick and have to have tests and hospital stays at the VHS hospital. A well balanced family medicare practice relies on - Self Pay, Insurance from those who are still working, and Medicare Supplements. It seems to me that they will be putting all their business eggs into one basket source.. never a good idea. Wondering out loud what they will do when the Feds change the reimbursement program for Medi Gap programs and they get less reimbursements? I know their are Medical Insurance experts who read TOV... Would love to read your thoughts on all of this...



Always grateful that we have TOV to work through life changes in TV....

Originally Posted by dbussone (Post 1232282)

You asked a question about payment & financing the practices.

The biggest change will be that the practices will no longer rely primarily on insurance fee for service payments. They, and United, will split a direct subsidy per enrollee from Medicare.