NY HBMC area lost many providers. Now the rest of us which is about 4 providers become responsible for patients far from our homes and usual territory. Will not be feasible to see every patient in a timely manner, UV’s and PDV’s will be difficult to cover effectively or efficiently. Many are not UHC patients but contracted private insurance. So my question is, does anyone know if private carriers are aware or informed that the services we are contracted for will no longer be as efficient or thorough due to RIF?
2 replies (most recent on top)
No, that would be too transparent and Optum is not that. They often sell something before having full staff or structure in place. And if it is successful, usually get greedy and buy another company, and ultimately destroy both. In the process, the care models may change. Still pitching/selling on the successful metrics of the old care model. Changing processes- or otherwise termed as making “efficiencies” - which are most likely due to the RIFS because of poor business decisions, and oftentimes negatively impacts patient ratio and care. No, no they won’t tell. They will have talking points if asked to skirt around any questions. But, eventually it will show up in their performance metrics. That’s when they will know.
Probably not but UHC has to follow a contract to provide whatever service they offered. In Houston some patients only received telephonic visits due to where they lived and lack of providers to cover the area.