EDITORIAL: Don't doctor with senior plans
From Medicare rules and exceptions to the volumes of changes laid out in the Affordable Care Act, keeping track of health care seems — perhaps by design — nearly impossible.
Thankfully, elderly patients have advocates in the York County Area Agency on Aging and other benevolent groups that can decipher the officious language and see through the red tape that makes it clear our modern health care structure is more about growing empires and preserving profits than making life easier for people who need help.
So seems to be the case when Geisinger Gold — a Medicare Advantage plan intended to create additional benefits by administering the coverage through a private company instead of through the government — recently told nearly 120 York area medical provider groups that Geisinger Gold will no longer accept them.
What that means is thousands of elderly Geisinger patients will no longer be able to visit their longtime doctors — physicians in such well-established facilities as Memorial Hospital and Orthopaedic & Spine Specialists — unless they want to pay for it themselves or perhaps switch plans. Because either of those options sounds like fun, right?
So many of these patients will have to choose different doctors, such as any number of WellSpan physicians who are approved — read "preferred" — through Geisinger.
Why would the insurance company make this move that's obviously confusing patients and frustrating those who want to receive treatment from the doctors who've treated them for years?
The letter Geisinger sent to the ousted physicians cited a new collaboration with WellSpan, which takes effect Jan. 1.
Here's what WellSpan spokesman Rick Ayers said about it:
"With the health care system in this country transforming from just helping sick people to managing the health of populations, we want to transform health care by improving the outcomes. By working with Geisinger, we think we enhance access and benefits to those in York and Adams counties."
How does forcing seniors to switch doctors transform health care or improve outcomes?
We're not so naive as to believe that much of anything insurance providers and health systems do (at least voluntarily) is strictly intended to improve patient outcomes. Otherwise, the governor's wife wouldn't have had to spank insurance companies for trying to avoid paying for 3-D mammograms even though they're preferred.
We understand that Geisinger and WellSpan, though it's technically a nonprofit, need to make money and want to shore-up as many Medicare patients as they can.
The final insult in this situation was the timing of a recent series of recruitment meetings in which Geisinger was trying to recruit more elderly Yorkers for its plan.
The recruiter never mentioned the upcoming changes to the list of accepted doctors, but the meeting did feature a promotional video in which one senior woman gushes, "I can have my own doctors."
We think Geisinger should make good on that promise.
But how about at least grandfathering current Medicare patients so they can continue to enjoy their relationships with their existing physicians?