Patient advocates say the exclusion of one of Missouris top hospital systems from policies offered by the regions biggest insurer under the Affordable Care Act could hinder treatment for some patients and force others to switch doctors.
The network for the Anthem BlueCross BlueShield plans, which will be sold through Missouris Obamacare marketplace, does not include BJC HealthCare and its 13 hospitals -- among them Barnes-Jewish Hospital, the areas premier academic medical center, and St. Louis Childrens Hospital.
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The plans are similar to narrow networks assembled elsewhere by Anthem and other insurers to bypass higher-priced health systems and offer more-affordable coverage. But consumer advocates worry tighter networks will disrupt care and limit access for middle- and lower-income consumers, many sicker than average.
With only one other insurer besides Anthem planning to sell policies through the exchange in eastern Missouri, the region will have some of the most limited choices anywhere under the health acts marquee innovation, new federal data show. The other insurance company has not been identified.
Anthem recently briefed insurance brokers on its Missouri network.
We knew it was going to be narrow but it surprised us about the hospitals left out, said Adam Berkowitz, a benefits consultant with Caravus. It was kind of eye-opening.
Consumer Groups Criticize Anthem?s Narrow Network In Missouri?s Obamacare Marketplace - Kaiser Health News