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Talking Affordable Health Care Act and Hospital Safety with Jud Knox, CEO
Q. Tell us about the Affordable Health Care Act and how it affects York Hospital. May I offer something on which I think we all can agree? It’s impossible to turn on our tv’s, radios, computers or smartphones without constant updates and opinions on The Affordable Care Act—a method for all Americans to find affordable health insurance options, known as the Health Insurance Marketplace. We’ve found here at York Hospital that not only has “the marketplace” been a topic of national news, but it has also begun to affect us at the local level.
Q. What plans on the Health Insurance Marketplace offer coverage at York Hospital? There are two insurance companies offering plans on the Marketplace in Maine. The first, “Maine Community Health Options” offers several plans that cover care at York Hospital. It is important to note that the other insurer - Anthem Blue Cross Blue Shield - also has plans on the Marketplace, but they have opted to NOT cover care at York Hospital.
Q. So, what if I already have Anthem Blue Cross Blue Shield - can I still use York Hospital and its services? The short answer is “yes”. Right now, if you already have an Anthem plan, you will be covered for services both at York Hospital and with our providers. That includes Medicare Supplemental and Advantage plans, Federal plans and most other insurance products. However, it’s always a good idea to double check the particulars of your own situation with a phone call to your insurance provider.
Q. Why aren’t Anthem Blue Cross Blue Shield’s new Marketplace plans covering services at York Hospital? Let me stress that it is not due to any type of “deficiency”, but simply a business decision on the part of Anthem BC/BS. When asked, we were not provided with any criteria that needed to be met in order to be included in the network. And we aren’t the only hospital left out. Anthem’s decision was purely economic, opting to exclude 6 of the 38 hospitals in Maine – York Hospital, Central Maine Medical Center, Bridgton Hospital, Rumford Hospital, Parkview Adventist Medical Center and Mercy Hospital – in its new narrow network Health Insurance Marketplace plans.
Q. Will York Hospital ever be included in the Anthem Blue Cross Blue Shield Marketplace Narrow Network Plans? I hope so…if the system is fair.
Q. I know I want to use York Hospital, but haven’t yet chosen a “Marketplace” insurance plan…what should I do? You should contact Maine Community Health Options (MCHO). They are a non-profit, Maine-based consumer operated and oriented health insurance plan offering coverage for services at York Hospital along with our network of physicians. Their products feature a range of benefit plan designs and a robust network of healthcare providers - in state and out. To learn more, visit www.maineoptions.org or call 207-402-3330.
Q. I’m still a bit confused and not certain about what’s right for me or my family—who can I talk to? To learn more about the Health Insurance Marketplace, available tax credits, income-based subsidies, or for help signing up, contact York County Community Action at 207-459-2989.
Q. One more question, unrelated topic. Maine hospitals have been making headlines for stellar safety scores on a recent national Hospital Safety score report. What was York Hospital’s grade? We were recently honored with an “A” grade by the Leapfrog Group’s national “Hospital Safety Score”, which rates how well hospitals protect patients from accidents, errors, injuries and infections. Maine hospitals ranked first in the nation with 80% of hospitals scoring an A. We are really pleased that Leapfrog Group Hospital Survey Grading recognized the high quality care that York Hospital provides. There are a number of national hospital grading groups that use different criteria and complicated scoring mechanisms to grade hospitals—it’s our responsibility to understand them. The “A” grade reflects what we’ve ALWAYS done here. Are we pleased with their assessment? Yes—because it affirms what we’ve always believed.
As always, Jud welcomes your comments. Feel free to e-mail him a question here.
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