From the Texas Medical Association website:
Both Texas Oncology and ARC, for example, already participated in most major health plans in Texas before the launch of the exchange. Because not all of those insurers explicitly invited Texas Oncology to join their new marketplace networks, the group was combing through its contracts and contacting carriers to find out how to opt out of the exchange plans. All of ARC\’s existing contracts require insurers to renegotiate with the group before including it in any new products or networks. Some payers never approached the group; others came back with lower fee schedules, which ARC declined. On the other hand, 27 percent of respondents in the MGMA survey said they are participating in the exchange because their existing contract terms required them to participate in all of an insurers\’ products under so-called \”all products\” clauses.
Because a number of Dr. Buckingham\’s contracts include such clauses, the six-physician practice, Eye Physicians of Austin, faces the prospect of renegotiation in order to opt out of certain exchange plans.
\”To me, my hands are tied, and they are making me jump off of a plank I don\’t want to jump off of. And it\’s an expensive process, and it interrupts patient care,\” she said.
via Untested Waters.
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