Besides concerns about a federal bill that could leave Medicare
reimbursements flat in San Benito County, local physicians are
worried about changes to reimbursement payments from Blue Cross of
California.
Besides concerns about a federal bill that could leave Medicare reimbursements flat in San Benito County, local physicians are worried about changes to reimbursement payments from Blue Cross of California.
The largest for-profit health plan in the state is changing its doctor reimbursement rates starting August 6. The company will be slightly increasing reimbursement rates for regular office visits, but decreasing rates for some procedures by up to 28 percent.
This has many local doctors concerned they will have to stop accepting the insurance, which accounts for one of the largest portions of patient insurance in the county.
Dr. Ralph Armstrong, a doctor at Hazel Hawkins Hospital, said that on average 35 percent of local doctors’ patients use Blue Cross, with some serving up to 50 percent Blue Cross patients. According to Blue Cross of California, 55 doctors and specialists in San Benito County accept the insurance.
Doctors will see a 4 percent reimbursement hike for a standard office visit with a primary care physician, Armstrong said. But surgeons and specialists will see a 28 percent decrease in the insurance’s rates for a colonoscopy with the removal of a polyp.
Armstrong, who serves as the San Benito County Medical Society president, wrote a letter to the California Medical Association on behalf of the society expressing concerns over the decreases.
Nick Garcia, spokesman for Blue Cross in Northern California, said the rates changed in an effort to attract more primary care physicians. He said it was part of an effort to increase the health of their patients by ensuring they get regular checkups.
“It’s important to note that our commitment is to our members. That’s what is most important to us,” he said.
Still, it’s patients who will be most affected if doctors stop accepting new patients or accepting the insurance altogether because costs are too high, Armstrong said.
“If doctors stop taking new Blue Cross patients, that’s going to affect access to care within San Benito County,” Armstrong said.
