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Obamacare may limit hospital choices in NH

Friday, September 06, 2013, 7:44pm
(NECN: Lauren Collins, Concord, N.H.) - Most people and small business owners have many unanswered questions about the Affordable Care Act.

"What [do] we need to do, what procedures need to happen?" are questions David Constant, who owns Constantly Pizza in Concord, N.H., and his brother have been asking. "So no, we're not informed at all."

Add one more question: Where do I go for care? Anthem Blue Cross Blue Shield is the only company to offer plans on New Hampshire's health insurance exchange. That's the marketplace set up for people to shop for individual plans.

The insurer has cut 10 of the state's 26 hospitals from the network available under that coverage.

Concord Hospital is one of them. CEO David Green says Anthem's proposed reimbursement rate is too low.
     
"If you accept those rates from Anthem, do you have to accept those rates from everybody else?" posed Green. "If you accept them for the exchange product, is Anthem then going to push you to accept those rates for commercial products?"

A press release from Anthem on the network list states, in part, "Anthem is choosing to offer this select network of providers to offset the premium increases that would otherwise be necessary ... Without the use of the new network, all individual exchange members would have seen much higher premiums than they will now see."

"There's kind of a lack of information and understanding right now about how it's all going to work,” said political commentator Dean Spiliotes. "At least initially, in Anthem's mind, a narrower network is going to be more efficient and more cost effective."

Health care advocates are worried about access, especially for those in New Hampshire's North Country who may have to drive more than an hour to the nearest in-network hospital.

Green says, for now, don't panic.

"I guarantee that by 2015 there will be more choices and Concord Hospital will be a provider on the exchange," he said.

Emergency care and treatment for ongoing serious illness are not impacted. Health plans become available October 1 and take effect January 1.
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