UnitedHealth dumps more docs from Advantage plans

UnitedHealth Group is continuing to eliminate physicians from its provider networks for Medicare Advantage plans in states across the country.

In recent weeks, doctors in Alabama, Georgia, Massachusetts, North Carolina and Tennessee have received pink slips. The Minnetonka, Minn.-based insurer has not disclosed how many doctors it's dropping in each state, but a spokesman said it expects to slim its networks to 85% to 90% of their 2013 size. Doctors will have the opportunity to appeal. “We are taking steps to support our members (who) are changing physicians, including helping to ensure that individual courses of treatment and ongoing care needs are not disrupted,” UnitedHealth spokesman Terry O'Hara said.

In Massachusetts, UnitedHealth said the numbers of doctors in its Advantage network would shrink by no more than 4%. Medical Association of Georgia officials said UnitedHealth told them it was cutting its Advantage network there by 10% effective Sept. 1. The Tennessee Medical Association estimates that 500 doctors will be tossed effective Aug. 15. Russ Miller, the TMA's CEO, said his group received no clear indication from the insurer on what prompted decisions about specific physicians. “It sounded like they only want to do business with large groups,” Miller said.

The wave of network cuts continues a trend established last year, when doctors in Connecticut, Florida, Missouri, New York and Ohio, among other states, were dropped from UnitedHealth's Advantage plans. In Connecticut, two county medical associations sued to challenge the cuts. A federal judge in December granted an injunction, which was affirmed on appeal, granting doctors the right to appeal through arbitration.

Congressional Republicans have blamed the healthcare reform law for the network cuts. Rep. Rosa DeLauro (D-Conn.) announced she would introduce a bill to block insurers from dropping doctors in the middle of an enrollment year.

Despite the protests, John Gorman, a Washington-based consultant who works with insurers, expects more network narrowing as insurers adjust to Medicare Advantage payment cuts mandated by the reform law. “This has become do or die now for these plans,” he said.

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