This leads to shorter visits and more care delivered over the phone. Medical Groups Downsizing Another way some HMOs control costs is to limit the number of physicians in the medical group, says Weissman. This is a significant change, as it means your doctor may be accessible through only one medical group. Weissman recommends you speak directly with your primary care physician choice about which health insurance plan and medical group the physician plans to stay with and prefers to work with. Even though our UC health benefits package is standardized, the insurance company delegates much of the administration of the plan to the medical group.
Some medical groups are more flexible than others.
Also, adds Weissman, medical groups maintain their own panel of specialists. If you anticipate referrals to specific specialists next year, explore their accessibility as well. It may be no surprise that Consumer Reports, using their own criteria, found the highest rated plans were non-profit. They hypothesized that non-profits still cling to a sense of mission that goes beyond the bottom line. What You Can Do Do your homework.