Health insurers under pressure to keep premiums low are eliminating some hospitals from coverage in a cost-cutting strategy that threatens to freeze out centers that provide specialized care, limiting patient options.
Left out are hospitals such as Seattle Children’s, excluded from five of seven plans on Washington’s state insurance exchange. The hospital, which has sued the state to be included in more plans, is struggling to get paid for care given to about 125 children since Jan. 1, when Obamacare coverage took effect, said Sandy Melzer, the facility’s strategy officer.
In January, “we made the decision to see all the children,” Melzer said by telephone. “Maybe we’ll be paid, maybe we won’t. It’s completely done on faith.” If the insurers refuse to cover their services, the hospital will pick up costs that go beyond the standard deductible, he said.
The insurers’ strategy, outlined in a report last month by the McKinsey Center for U.S. Health System Reform, is an unexpected consequence as the 2010 Patient Protection and Affordable Care Act, known as Obamacare, kicks into gear.
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