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Poll: Tiered Health Plans -- Good, Bad, or Indifferent for Patients and Providers?

Everyone likes to save money, but what if it means not seeing your primary care doctor or visiting the hospital where you’ve been treated?

With great fanfare, Horizon Blue Cross Blue Shield of New Jersey has rolled out the OMNIA Health Alliance, a group of hospitals that say they’re committed to transforming healthcare. Instead of paying providers based only on the number of services they deliver, alliance participants will be paid partly for furnishing high-quality care, and partly for controlling costs.

How this works should become clear next month, when public workers who are in the State Health Benefits Program will be offered a “tiered” health plan. Patients who go to OMNIA members and other Tier 1 hospitals should see out-of-pocket costs cut by $2,000 a year, and will pay lower monthly premiums. The catch? In order to get those savings, some patients will have to give up on doctors or hospitals with which they have long-time relationships.

What do you think of the move to tiered health plans?

  • Anything to lower the cost of healthcare is welcome, and I would gladly put up with some restrictions on where I can be treated in order to pay less.

  • I’m not thrilled about being told which doctors or hospitals I can use in order to qualify for lower prices. But at the end of the day, healthcare is getting too expensive; I’ll likely make the tradeoff in order to lower my family’s medical bills.

  • While it all sounds reasonable in theory, Horizon and other insurers offering tiered plans should make the details available as soon as possible. This is particularly true for public workers, who only have the month of October to decide whether they’re switching plans.

  • We need to lower healthcare costs, but this is the wrong way to do it. Leaving nearly half of the hospitals in the state out of the lowest-cost tier is unfair to patients. Horizon should go back to the drawing board and build a bigger tier 1.

  • I’m sick of insurers putting pressure on providers. We don’t need to pay doctors and hospitals less. Insurers should reduce their own profits before asking anyone else to make sacrifices.

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