Concerns Raised About Doctor Choice under Affordable Care Act - 8 News NOW

Concerns Raised About Doctor Choice under Affordable Care Act

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CORRECTION: Initially 8 News NOW reported St. Rose Dominican Hospital was not on the exchange. Actually the hospital is participating in the exchange through HPN. 

LAS VEGAS -- There is growing concerns over the impact the Affordable Care Act will have on doctor choice.

There is some fear that more doctors and hospitals will choose to not to accept insurance plans from the exchange. However, there are no clear numbers to support that concern at this point.

Some insurance brokers, who sell insurance, say doctors are opting out of HMO-based plans on the exchange, but medical professionals say there is no cause for alarm just yet.

As the Affordable Care Act has rolled out, Anthem an HMO, Health Plan of Nevada and Nevada Health Co-op are all participating in the Silver State Health Exchange.

There are several plans not in the exchange, including Aetna, Coventry, Humana, Anthem Blue Cross and Assurant. People can still purchase plans from these companies as individuals.

For people who have not bought insurance through the exchange, nothing will change.

For those looking to buy a plan through the Silver State Health Exchange, they will need to do their research about which insurance will be accepted where.

"The networks are all HMO. So, the networks are smaller, are narrower," insurance broker Larry Harrison said.

Larry Harrison is an insurance broker with National Healthcare Access. It is his job to help sell insurance, in or out of the exchange.

He says the three HMO-based plans on the exchange could leave people with fewer choices, when it comes to doctors and hospitals.

He says doctors will not get as much money from an plan in the exchange as an out of exchange plan and will decided to not accept that health insurance plan.

"The doctors will not be reimbursed as much as they would like to be," Harrison said.

Dr. Bard Coats, an executive with Healthcare Partners Nevada, says everyone needs to wait and see what happens.

"The overall picture cannot be spread that easily. It is very unique per market," Dr. Coats said.

So far, he hasn't heard of any doctors dropping insurance companies involved in the exchange.

"We're not seeing that, certainly from our vantage point," Dr. Coats said.

Brian Brannman, the CEO of University Medical Center, agrees.

"It probably will not be as extreme as anyone is saying. It will all settle somewhere," Brannman said.

Both say Nevadans need to see how the Affordable Care Act rolls out over the next few years.

Across the board, both insurance brokers and medical professionals say people should check with their doctors or hospitals to see what insurance carriers they are taking before choosing any kind of health insurance.

People who do not have insurance have until Dec. 23 to pick a plan and pay for it to be enrolled by Jan. 1.

To get information about the health insurance plans, go to nevadahealthlink.org.

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