HomeInsuranceHealth care safety net threatened by insurance company | Opinion

Health care safety net threatened by insurance company | Opinion


Keeping low-income families healthy is challenging enough without Medicaid-managed care corporations like Centene, parent of Arizona Complete Health and Care1st Health Plan Arizona, reducing access to care. 

Centene recently terminated its contract with Tenet Healthcare, which operates Abrazo Health, because our hospitals were unwilling to accept enormous rate cuts. The termination threatens our health care safety net as well as the health of low- and fixed-income patients in the greater Phoenix area. Patients with health insurance from Arizona Complete Health, Care1st Health Plan, Wellcare and Ambetter will no longer have in-network access to doctors at Abrazo starting Jan. 1. 

Across the country, economic pressures during the pandemic have increased Medicaid enrollment. The majority of Medicaid recipients are in Medicaid-managed care plans like Centene’s Arizona Complete Health and Care1st Health Plan. According to KFF, Medicaid covers 1 in 5 adults, 3 in 5 nursing home residents, and 1 in 3 individuals with disabilities in Arizona. But that coverage is only helpful if it increases access to care and makes those patients less likely to postpone care due to cost. 

Families from across southwest Arizona receive access to critical care services at Abrazo West Campus, a full-service hospital that includes a Primary Plus Stroke Center and Level I Trauma Center. By cutting Abrazo Health out of its network, Centene is getting in the way of patients accessing the care they need from a trusted provider that also includes our sister Abrazo hospitals in Glendale, Scottsdale and Phoenix. 

Patients on limited and low incomes will now have to travel farther for care or will be forced to pay out of pocket, putting additional financial strain on these households. Centene is forcing thousands of Arizona families to make impossible decisions about their health care. 

Centene’s actions unduly affect a population that often experiences a higher prevalence of acute care. These patients often delay care until their conditions worsen and they require more serious attention. Losing in-network access to Abrazo Health hospitals would exacerbate this problem and contribute to poorer health outcomes. For many Valley families, eliminating Abrazo doctors from their network may leave them without one.

Centene is making it harder, not easier, for patients to get care. Centene — reach a deal that prevents disruption and protects access to Abrazo Health hospitals for our community.

Dr. Sushant P. Kale, MPH, FAHA, is an interventional neurologist at Abrazo West Campus in Goodyear. He is board certified in neurology, vascular neurology and neurocritical care, with more than 15 years of clinical and academic experience.



Source link

latest articles

explore more