More on Dying for Care

6

THE EXCHANGE
‘It's really a new market’

When people across the country can search for health plans later this year, insurance carriers will try to convince millions to sign up for their health care plan over others.

This may cause health care premiums to drop as insurance companies battle for customers.

New York City-based insurance company EmblemHealth, serving 2.8 million current members, is preparing to become more retail-based. Workers are shifting from their longstanding focus from catering to employers, said Paul Zurlo, EmblemHealth's senior director of new business development. The company is opening offices in Harlem and Cambria Heights, Queens, so staff can encourage individuals to enroll in plans.

“It's really a new market of targeting the consumer rather than the employer,” he said.

Sally Kweskin, spokesman for Empire Blue, Blue Cross Blue Shield's New York City health plan, said the company declined to comment for business and competitive reasons.

Another likely change is an increase in the number of doctors accepting Medicaid, Fentiman said.

Medicaid recipients were traditionally limited in options because physicians received low payments in return for the services they provide. At the start of 2013, states have to pay primary care doctors no less than 100 percent of the rates they pay for Medicare, which has typically paid more than Medicaid.

“This will help those who are underserved see a regular physician and you'll be more likely to get yourself treated,” Fentiman said.

For clinics like the Community Healthcare Network, the health care law is expected to make more financial resources available.

Matthew Weissman, the doctor at the federally-funded Community Healthcare Network, said the increased funds will expand care. The Affordable Care Act set aside $11 billion to increase services and expand community health centers during the next five years.

Weissman also said while he expects the uninsured population at the clinics to shrink, he anticipates more people will start looking for medical care because they will be covered.

“To me,” Weissman said, “getting more people insured is a big benefit because it means people will be more likely to come in for preventative care and more likely to treat illnesses earlier.

“It makes it easier for us to get things done that need to get done because patients won't be thinking, ‘I don't know if I need that blood test because I don't think I can afford it.’”

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Part 7: The Pain »

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