October 9, 2013

United Healthcare drops thousands of CT Medicare Advantage docs

The Hartford offices of UnitedHealthcare in the CityPlace I building.

Health insurer United Healthcare, which has major operations in Hartford, has notified more than 2,200 Connecticut doctors that it will drop them from its Medicare Advantage plan in February, the Fairfield County Medical Association reported on its website.

The association, which represents doctors and other medical professionals, charged that UHC is making the change to boost its rating from the federal Center for Medicare Services, which would translate to higher reimbursements.

"UHC is obviously looking to increase its profitability," the association wrote yesterday on its website.

The 810 primary care physicians and 1,440 specialists represent 19 percent of UHC's physician network in the state, according to the association.

Quality-incentive payments to insurers under CMS' five-star rating system for health plans will get stricter in 2014, eliminating payments to any plan earning fewer than four stars. Over the past two years, plans with 3 or 3.5 stars received payments.

According to a study by the Kaiser family Foundation, United received $540 million in bonus payments in 2012 — the largest share for any single carrier. United had a CMS rating of 3.17 stars that year, according to the study.

United wouldn't confirm the Fairfield association's claims about the number of impacted doctors or the reasons for the cut.

In response to questions about the doctor cuts in Connecticut, a United spokesman sent a statement this morning saying United is "building a network of health care providers that we can collaborate with more closely to have the most positive impact on the quality of care for our members."

"This will encourage better health outcomes and ultimately lower costs," the statement said.

The company said it's working with affected members to help them find new providers and that patients enrolled in its commercial, Medicaid and Medicare supplement plans are not affected by the changes.

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