Tuesday, October 30, 2018

Two Hospitals Drop Medicare Advantage

Insurance Commish Mike Chaney issued the following statement.

The Mississippi Insurance Department learned this week that Southwest Health System located in Pike County, Mississippi will drop its Wellcare Medicare Advantage agreement at the end of the year.

Once the Medicare Advantage network agreement ends, some visits would be considered out-of-network and policyholders would receive reduced benefits.

Insurance Commissioner Mike Chaney said, “We do not regulate Medicare Advantage plans. That’s the federal government. We do, however, get involved to protect the consumer because it’s such a hot button issue. From what we understand, Wellcare has over 30,000 Advantage consumers in the state. They tell us that they only have 800 in Pike County and that they are working to secure several facilities that will see Wellcare patients within 10 miles of the hospital.”

Patients may go to other in-network hospitals in the area including: Kings Daughter Medical Center, Walthall County General Hospital, and Marion General Hospital.

A similar situation is playing out in Tupelo. North Mississippi Health System is ending a multi-year Medicare network agreement with Humana on December 31, 2018. Humana has reported that negotiations with the hospital, started in June 2018, have been unsuccessful.

Commissioner Chaney says this is an example of reimbursement issues.

“We’ve had 5 hospitals close since 2013 and four have filed bankruptcy in the past three weeks. There will be more if we don’t get a handle on the problem,” Chaney said.

Alternative in-network hospitals in North Mississippi include Baptist Memorial Hospital with several facilities, OCH Regional Medical Center in Starkville and Trace Regional Hospital in Houston, MS.

Patients should consider other healthcare plans but they need to do so quickly. Medicare Open Enrollment started October 15th and continues through December 7, 2018. Once enrolled in Medicare, consumers can choose supplements or Medigap for expenses not covered by Medicare.

Consumers can visit www.mid.ms.gov to look at Medicare plans and shopper’s guides.

Those with questions for Wellcare should call the Customer Service number on the back of their insurance card.

Humana Medicare providers in North Mississippi with questions or concerns should call the Humana customer service toll free number (800) 457-4708.

Humana Medicare members in North Mississippi with questions or concerns should call the toll-free phone number on the back of their Humana ID cards.

Kingfish note: Has anyone noticed how many hospitals in Mississippi are losing money?  Numerous county and rural hospitals are running in the red.  However, the big boys aren't doing too well, either.  MBMC was losing millions of dollars before it  merged with the Baptist system in Memphis.  It's no secret UMMC is losing money thanks to budget cuts.  It's also a safe bet that St. Dominic wasn't taken over by the Our Lady of the Lake system in Baton Rouge because it was doing so well.

So when do our so-called leaders start talking about this problem?


Anonymous said...

Our leaders are talking about the healthcare issues. They don't think you should have healthcare unless you can afford to pay out of pocket to a private provider. They think it's socialist to help people.

Anonymous said...

Maybe if self inflicted obesity related issues would quit flushing taxpayer dollars down the drain Medicare and Medicaid could afford to reimburse those doctors and hospitals in a timely fashion. Ask the bankrupt hospitals what percentage of their patients are in for issues caused by being morbidly obese and/or noncompliant diabetics. Taxpayers pay for them to become obese through SNAP when they buy soft drinks and carb heavy processed food, then have to pay for their treatment through Medicaid and Medicare.

Anonymous said...

@12:23- it’s the very act of TRYING to socialize medicine that created the situation to which these hospitals have succumbed. It is BECAUSE they are providing healthcare FOR WHICH THEY ARE NOT GETTING PAID that is bankrupting them. How can they pay THEIR BILLS ....the doctors, nurses, x-ray techs, etc. and pay the light/water bills, and buy the machines, buildings, bandages and medicines necessary to make sick people well if they aren’t getting paid for having provided that medical care????

Anonymous said...

"Coverage" for pre-existing conditions is not insurance. It is welfare.

Anonymous said...

They wont talk about it because calling a spade a spade is frowned upon these days and you get called all kinds of names. Plus its bad for job security(re-election). Truth is medical care is expensive and to be forced to do work for anyone who enters your door and not get reimbursed in full or paid at all costs the hospitals money. At the end of the day both hospitals and insurance companies are not Non Profit entities like the socialists would like for them to be. Going to the ER for a common cold so you don't use your Medicaid visits hurts the hospital and other patients in the end.

Anonymous said...

@2:06 Excellent post....on the mark.....but will be rapidly changing over the years to come. The question should be in these articles: Who was behind the capital expenditures that built these facilities that didn't have true long term viability? Seems like there's a lot of things like this in Mississippi that don't serve a purpose except for a Roger Wicker type to cut a ribbon and claim responsibility for it getting built, just so they can garner votes.

Anonymous said...

Kingfish note: Has anyone noticed how many hospitals in Mississippi are losing money? Numerous county and rural hospitals are running in the red. However, the big boys aren't doing too well, either. MBMC was losing millions of dollars before it merged with the Baptist system in Memphis. It's no secret UMMC is losing money thanks to budget cuts. It's also a safe bet that St. Dominic wasn't taken over by the Our Lady of the Lake system in Baton Rouge because it was doing so well.

OK - We should immediately fire the management teams and any people working on the financials. We should also see to it that staff is cut (especially the damned slackers), salaries and benefits are reduced and....WAIT...I thought this was the PERS thread.

Anonymous said...

Lot of nonsense explanations on here. Most of this nonsense can be cleared up by separating quality of healthcare from payment for healthcare. Advances in quality have led to ambulatory services drastically reducing hospital occupancy. The rural hospitals are insolvent because the rooms are empty. The rooms are empty because the quality of many medical procedures no longer requires hospitalization. Therefore, the revenue stream is gone and the rural hospitals can longer pay for operating rooms that can be mass produced elsewhere. This has nothing to do with insurance coverage. These rural hospitals should not be subsidized any more than a dying shopping mall should be. Yep, you are going to have to travel somewhere else to get your spleen removed. However, the bigger quality of care issue that you are all missing is the stunning number of medical errors that are occurring in these big medical centers all across the U.S. That’s where you ought to be alarmed.

Anonymous said...

“Coverage” for pre existing conditions is not welfare fool...it’s spreading the cost of illness among a larger sect so people can live.

I sincerely hope your entire family has cancer of the fingers and they need help but can’t get it.

Anonymous said...

Remember we support existing conditions.,.

Anonymous said...

No, 7:19, compelling me to pay money into a group to take care of others with pre-existing conditions is not insurance; it’s tyranny. If I choose to pool my resources with thirty other families and we agree to only provide for future medical events that each exceed $10,000, that is our business and no one else’s. If my children get cancer of the fingers (which apparently you wish that they do) and my group does not have enough funds to pay for treatment, then I and my children suffer the consequences of my decision. The idea that I then have some right to a higher level god who will compel others to pay for the cancer treatment is not only ridiculous, it is confiscation. Plus, it means handing over my welfare to this god and this god’s rules. On the other hand, if you have children with cancer and no alternatives, I can choose to help you or not choose to help you. It’s called charity. However, you have no right whatsoever to my assets.

Anonymous said...

How much money has just the pain cream operation out of Hattiesburg cost us? Millions from just one small group. Provider fraud is a huge issue but it is white collar so we largely ignore it.

Anonymous said...

We grossly overpay doctors compared to every other Western nation.


Anonymous said...

you could go a long way towards ending the obesity epidemic by removing government corn and beef subsidies. Your 99 cent McDonald's cheeseburger will now cost much much more.

Anonymous said...

I think there is a unique solution to kill a few birds with one stone. We have a massive overpopulation issue that affects everything. It is depleting all our natural resources and ruining the environment. Clearly our older population is a drain on our healthcare as they are living too long and driving up costs. We should just cut people off at 60 from pharmaceuticals and expensive treatments. That will do away with Medicare like the right wants and fix the environment like the left wants. Everybody wins!

How Long Have You Had This Limp? said...

Devil's advocate here: If so-called pre-existing conditions were not covered by HIPAA regulation, upwardly mobil folks with an illness would be dead in their tracks as far as changing jobs. You'd be hesitant to switch careers or take a job with another employer in order to advance in your chosen field.

The 'P' in HIPAA simply means that insurance coverage from one job to the next is 'portable'...insurance coverage can't be denied if you change jobs (in a nutshell).

Nobody is 'sticking it to' the pool-snobs who think they're in a safe capsule with people having zero illnesses.

Anonymous said...

Let's take a look at this comment:

"Coverage" for pre-existing conditions is not insurance. It is welfare. October 30, 2018 at 3:29 PM

So...if the person who posted that is, say, an accountant and manages to get an MBA and searches the job boards and applies for a position as a Senior Auditor or Accounting Manager at another company and he gets that job....and he happens to have two heart stents and is on three control meds....He is going on welfare if the new employer's plan covers him?

Anonymous said...

I agree with 2:06. We should outlaw sodas, sugar, trans fats, high fructose corn syrup and other plagues on the state's citizens' diets. Maybe if we outlawed mcdonalds and wendys, we could get these costs under control. It's clearly not working to let people make their own dietary decisions.

Anonymous said...

Prior to HIPPA most Group plans waived pre ex on new employees who had prior coverage. Granted individual plans did not. The issue is and the reason for the mandate was to attempt to prevent individuals from waiting until they nad an issue before buying coverage. What if you could wait until your house was on fire, damaged by a storm before you bought coverage.
There are ways to correct the issues but getting all parties, Users, providers (Drs, Hospitals, big Parma) insurance, and. Govern,ent to agree seems impossible

Anonymous said...

That's not stringent enough 5:45 PM.

Required periodic weigh-ins for the obese with mandatory loss targets. Miss your weigh-in or target, suffer a fine or loss of benefits or both.

If we're forced to pay then everyone with lifestyle inflicted health care problems are forced to pay.

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Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.

Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything).

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In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.

In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.

Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.

Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!

This is definitely a Beaver production.

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Jackson Jambalaya is the home of Trollfest '07. Catch this great event which promises to leave NE Jackson & Fondren in flames. Sonjay Poontang and his band headline the night with a special steel cage, no time limit "loser must leave town" bout between Alan Lange and "Big Cat"Donna Ladd following afterwards. Kamikaze will perform his new song F*** Bush, he's still a _____. Did I mention there was no referee? Dr. Heddy Matthias and Lori Gregory will face off in the undercard dueling with dangling participles and other um, devices. Robbie Bell will perform Her two latest songs: My Best Friends are in the Media and Mama's, Don't Let Your Babies Grow up to be George Bell. Sid Salter of The Clarion-Ledger will host "Pin the Tail on the Trial Lawyer", sponsored by State Farm.

There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.

If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

This is definitely a Beaver production.

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