The contracts vary throughout the year and by individual health plan. If the parties of the joint contractors could not agree on the renewal terms, a reduction of providers could result. Even though the proposal states the individual physicians could then negotiate with the health insurance plans, in certain circumstances the individual physician may not be able to compete with the group of physicians. Joint negotiations could also end with higher reimbursement costs. If the group represents a significant share of providers in the service area, the group of physicians would demand higher capitation rates.
Higher rates require higher premiums from employers.
However, the overall cost impact cannot be determined at this time. SOS states that based on experience with other divisions, the rules, regulations, and forms issued by the Attorney General could require as many as 20 pages in the Code of State Regulations . For any given rule, roughly half again as many pages are published in the Missouri Register in the Code because cost statements, fiscal notes, and the like are not repeated in Code. These costs are estimated. The actual cost could be more or less than the numbers given.