Medscape surveyed over 6300 physicians, primarily for their views on various health plans. 64% of respondents were mail, 9% worked in primary care, 45% were in a physician-owned solo or group practice and 40% were either hospital-based or in a hospital-owned group. (Insurer Ratings) In regard to which large health plans they are contracted with, 87% said Aetna, 85% the Blues plans and UnitedHealthCare, and 82% Cigna. Important factors in participating with a plan are almost all linked to pay, such as the level of reimbursement, the number of denials, ability to get denials reconsidered, speed of payment and general ease of doing business. The majority of doctors, 82% contract with 6 or more health plans. 84% accept Medicare and only 5% have stopped accepting it in the last two years, but 12% said they will stop participating in 2015. Only 65% currently participate in Medicaid, 12% have dropped it in the past two years and 21% plan to end participation in 2015. The physicians who do accept Medicaid generally report an increase in Medicaid patients since the advent of the reform expansion. We have to wait and see what doctors actually do, but the stated intent to drop Medicare should be carefully watched and if 21% actually left Medicaid, that program will have a very difficult time with access to physician services.
Physicians were asked to rate plans on a 1 to 5 scale. The rankings are generally clustered and no plan scores really well on any issue. The top three on an overall basis were the Blues plans at 3.3, Aetna at 3.2 and Cigna at 3.2. The major movement in the rankings was that UnitedHealthCare has trended down since 2011. As you might imagine, there is not real satisfaction with reimbursement from any health plan, but the Blues plans and Aetna rank best at 3.0. Medicare is at 2.5. There was some variance in rankings across specialties. Interesting to look at private health plan payments in comparison to Medicare. 27% of doctors said their average reimbursement from Blues plans was above 110% of Medicare rates, the highest among health insurers, while 40% said their average payment from Humana was at or below Medicare reimbursement. In terms of ease of doing business, the Blues come out on top slightly, at 3.2, followed by Aetna and Cigna at 3.1. The fewest claim denials are from Medicare, followed by the Blues. The Blues have the best ranking on speed of payment at 3.4, trailed by Medicare at 3.3. The Blues plans account for 65% of patient visits on average across these respondents, followed by UnitedHealth at 18%, and Aetna at 10%. The Blues are responsible for 60% of collected dollars, on average. Not a lot of great happiness with health plans out there in physician land, but then we already knew that.