[jane032657]

Health-care changes in The Villages leaves some scrambling for new doctors - Orlando Sentinel

[Duppa]

This is an important issue that ought to be explored.

[RickeyD]

Originally Posted by Duppa

This is an important issue that ought to be explored.

The Florida attorney general would be the go to guy.

[rubicon]

follow the money. the article spoke of a pay for performance scenario. It would be interesting to see what agreement was made between United Health Care and TVHCS. It would be interesting to know why those over 65 must enroll in United Health Care. Can this be an age discrimination issue???? Ask an attorney..if you can find one that would go up against TVHCS. Don't bother with the local politicians they will just do a head fake

the law was changed so that insurance companies could not discriminate because of health pre-conditions (insurability) . so can they discriminate based on age?? Can they get around the age issue by claiming they are not discriminating all one has to do is sign up for United Health Care. Hmmmmmmmmmmm..and the beat goes on and the Daily Sun will publish another extensive and glowing article about the joys of The Villages Health Care system

Perhaps my opinion is all wet? I just wish if it is for the benefit of residents affected by this change and the community in general those responsibile for this decision step up and give us the reason we are all adults here.

[Carla B]

What they said in their letter of July 12: "Because our superior care best aligns with Medicare Advantage we have decided to no longer accept Original Medicare...."
What they meant: "Because we are losing a great deal of money, we have decided to no longer accept Original Medicare..."

I don't think it has to do with age discrimination; after all, physicians don't have to accept Medicare patients period.

I wonder if TVHS ever thought of turning their system into a concierge practice. It might be more palatable to the Original Medicare crowd or maybe even all patients to pay a yearly fee to join, with the provision of not being forced into an Advantage program.

[rubicon]

Originally Posted by Carla B

What they said in their letter of July 12: "Because our superior care best aligns with Medicare Advantage we have decided to no longer accept Original Medicare...."
What they meant: "Because we are losing a great deal of money, we have decided to no longer accept Original Medicare..."

I don't think it has to do with age discrimination; after all, physicians don't have to accept Medicare patients period.

I wonder if TVHS ever thought of turning their system into a concierge practice. It might be more palatable to the Original Medicare crowd or maybe even all patients to pay a yearly fee to join, with the provision of not being forced into an Advantage program.

CarlaB makes sense I forgot that doctors do turn down medicare because of their reduced payment and not the patients per se. some practices are accepting only cash, give the paperwork to patients and asking patients to get their benefits from their insurer. You could get sick just getting sick the way this insurance thing is turning out

[Jayhawk]

Did anyone actually READ the story?

"Also, what The Villages Health is doing is part of a growing trend, as the health care system moves away from a fee-for-service model toward one that pays for quality and performance, experts say."

"Over time, more and more Medicare beneficiaries will face similar choices to the Villagers,"


"I go every year to the Mayo Clinic and have them check me out, and I don't want to give up my right to that," Gott said. "This is not for me. I can't give up all those rights."

It boils down to CHOICE. And what any of us choose today may be different next year. That's the way the world works.

[2BNTV]

Originally Posted by Jayhawk

Did anyone actually READ the story?

"Also, what The Villages Health is doing is part of a growing trend, as the health care system moves away from a fee-for-service model toward one that pays for quality and performance, experts say."

"Over time, more and more Medicare beneficiaries will face similar choices to the Villagers,"


"I go every year to the Mayo Clinic and have them check me out, and I don't want to give up my right to that," Gott said. "This is not for me. I can't give up all those rights."

It boils down to CHOICE. And what any of us choose today may be different next year. That's the way the world works.

I read it.

Nothing new in the article for those who want to debate this issue. There are people who feel a limited choice of providers. They also feel they have been lied to. Don't understand this is a choice made by TVH to model health care, the way they think the new wave of medical care should be.

I realize that it's about the money and TVH wanting to stay in business as they need to be making a profit. I also wish they could have found a way to include original Medicare with a supplement, as it so convenient for villagers, not having to change doctors.

"It is, what it is"!

[outlaw]

Originally Posted by RickeyD

The Florida attorney general would be the go to guy.

Uh, I don't think she's going to ruffle this developer's feathers. Lot's of future political donations to be had.

[Villageswimmer]

Originally Posted by 2BNTV

I read it.

Nothing new in the article for those who want to debate this issue. There are people who feel a limited choice of providers. They also feel they have been lied to. Don't understand this is a choice made by TVH to model health care, the way they think the new wave of medical care should be.

I realize that it's about the money and TVH wanting to stay in business as they need to be making a profit. I also wish they could have found a way to include original Medicare with a supplement, as it so convenient for villagers, not having to change doctors.

"It is, what it is"!

Yes, the article is simply a rehash of what we've seen before, right down to people quoted.

To me, it's not so much the decision that was made but the poor way it was handled. Things are achangin. True. When Gary Morse was in charge, I think perhaps the same decision would have been made (they need to stay afloat financially) but I think it would have been handled with some sensitivity and honesty. For example, I still haven't received "the letter" since they were sent third class and not forwarded. This is a mistake that could have and should have been rectified. No doubt there are many people still not aware of this decision who are in for a big surprise when they return. Inexcusable.

Furthermore, to think that there are folks who made their home buying decisions, at least in part, based on access to TVH, is unconscionable and sad. No wonder they're upset! Not blaming sales agents. I have no doubt they didn't know the plan. Perhaps they should have. Or at least been directed not to pitch TVH since some changes were in the works.

So the result is a PR nightmare which could have been mitigated to some degree.

Just MHO.

[graciegirl]

Originally Posted by Villageswimmer

Yes, the article is simply a rehash of what we've seen before, right down to people quoted.

To me, it's not so much the decision that was made but the poor way it was handled. Things are achangin. True. When Gary Morse was in charge, I think perhaps the same decision would have been made (they need to stay afloat financially) but I think it would have been handled with some sensitivity and honesty. For example, I still haven't received "the letter" since they were sent third class and not forwarded. This is a mistake that could have and should have been rectified. No doubt there are many people still not aware of this decision who are in for a big surprise when they return. Inexcusable.

Furthermore, to think that there are folks who made their home buying decisions, at least in part, based on access to TVH, is unconscionable and sad. No wonder they're upset! Not blaming sales agents. I have no doubt they didn't know the plan. Perhaps they should have. Or at least been directed not to pitch TVH since some changes were in the works.

So the result is a PR nightmare which could have been mitigated to some degree.

Just MHO.

Well said.

VERY well said.

[rubicon]

Originally Posted by Jayhawk

Did anyone actually READ the story?

"Also, what The Villages Health is doing is part of a growing trend, as the health care system moves away from a fee-for-service model toward one that pays for quality and performance, experts say."

"Over time, more and more Medicare beneficiaries will face similar choices to the Villagers,"


"I go every year to the Mayo Clinic and have them check me out, and I don't want to give up my right to that," Gott said. "This is not for me. I can't give up all those rights."

It boils down to CHOICE. And what any of us choose today may be different next year. That's the way the world works.

yea I posted about that yesterday and the question I had is that does this system mean that those over 65 have less a chance at meeting insurers performance expectations and so those 65 + are .more likely to get the boot. its one thing to fix a cold another to try and fix heart disease. I have read about much controversy about this performance system devised by the present Administration, the same Admin that gave us ACA

[Advogado]

My take on all this is that the Villages Health Care System is a for-profit operation run by the Developer. If the Developer feels that he needs to accept only United Health Advantage patients to maximize profits, fine. The Developer certainly has the right to do so, and there are alternative choices for the consumer.

However, my criticism of the whole operation is the way the Developer's Daily Sun, from the very beginning, has characterized the Villages Health Care System in advertisements disguised as news. The Daily Sun has constantly described the system as some kind of Marcus Welby, altruistic effort to make The Villages "Florida's Healthiest Home Town"-- rather than accurately describing the System for what it is: another Developer for-profit business.

By the way, I think that the System is probably the wave of the future-- for better or worse. I just would like to see a little truth in advertising on the part of the Developer and the Daily Sun.

[Villageswimmer]

Originally Posted by Advogado

My take on all this is that the Villages Health Care System is a for-profit operation run by the Developer. ...

However, my criticism of the whole operation is the way the Developer's Daily Sun, from the very beginning, has characterized the Villages Health Care System in advertisements disguised as news. The Daily Sun has constantly described the system as some kind of Marcus Welby, altruistic effort to make The Villages "Florida's Healthiest Home Town"-- rather than accurately describing the System for what it is: another Developer for-profit business...

...right, part of the dishonesty alluded to in my post. Why lie when you can tell the truth? There's no shame in a for-profit business.

The Marcus Welby stuff couldn't have been more condescending IMO.

[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.