Metro-East News

June 19, 2014

Thousands in metro-east, Missouri may need new doctors

UnitedHealthcare notified physicians that they will be removed from the company's Medicare Advantage plan on Sept. 1, which may mean thousands in Southwestern Illinois and Missouri will have to switch doctors.

It is the second round of cuts to UnitedHealthcare's Medicare Advantage physician ranks. UnitedHealthcare is the largest carrier of Medicare Advantage plans for seniors.

The cuts are said the affect less than 10 percent of area physicians, which would translate to fewer than 1,000 physicians.

UnitedHealthcare members should be notified by mail of a change in their doctors' network status.

The cuts include physicians in counties where UnitedHealthcare closed Medicare Advantage plans in recent years and physicians where duplicate agreements are in place.

In an emailed statement, United Healthcare spokeswoman Jessica Kostner said, "We believe these changes will improve the health care experience for UnitedHealthcare's Medicare members in the St. Louis area. At the same time, we understand that these changes can be unsettling.

"We urge UnitedHealthcare members to call our customer service number on their member ID card if they have any concerns or questions," Kostner continued.

Cardiologist Joseph Craft III, president of the St. Louis Metropolitan Medical Society, which includes some doctors in the metro-east, said the decision will affect thousands of patients in the St. Louis area alone.

UnitedHealthcare terminated nearly 100 Missouri doctors from the Medicare Advantage plan in April and said it plans to cut 5 percent to 7 percent of the more than 10,000 physicians in the area this year.

UnitedHealthcare does not expect to make any more changes to its size in region this year.

Much of the latest cut seems target dermatologists, ophthalmologists, gastroenterologists and orthopedic surgeons.

Dr. George Hruza of Chesterfield, president-elect of the American Society for Dermatologic Surgery, received the network termination on June 2. He said that at least 36 other dermatologists have been terminated -- nearly half of the skin specialists in the St. Louis region.

"This area has a lot of farmers, so a lot of people who have sun damage -- these patients are now asked to find another doctor," Hruza said.

UnitedHealthcare said the main factors for the change were the health industry's move toward quality over quantity and a closer collaboration between insurers and doctors. The provider said that with a smaller group of doctors, patient data could be shared better, too.

"We are working to make transitions to new doctors as smooth as possible and will do all that we can to prevent interruptions in care," Kostner said.

But Craft said, "The relationships (doctors) have with their patients is being disrupted arbitrarily, mid-contract term, with no explanation. It's not reasonable. It's not fair to patients to do that."

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