Anthem defends proposed insurance changes

AUGUSTA, Maine (AP) — Anthem Blue Cross and Blue Shield defended its proposal Monday to transfer about 9,000 Maine residents from their current coverage plans to plans that exclude several hospitals, a move that has been criticized as limiting people’s ability to choose their doctors.

Anthem officials told Maine insurance regulators — who will now decide whether to approve the proposal — that the changes will affect only a small number of Maine residents. Anthem also says the plan greatly reduces coverage costs.

Anthem is partnering with MaineHealth for the plan it’s offering on the insurance marketplace to be introduced under the federal health care overhaul. The joint plan leaves out six southern Maine hospitals, including Lewiston’s Central Maine Medical Center, Parkview Adventist Medical Center in Brunswick and Mercy Hospital in Portland. That means people would no longer be able to see their doctors there unless they switch plans.

Staff from the affected hospitals attacked the proposal Monday, saying it will hurt their patients by forcing them to give up relationships they’ve established with doctors and drive farther for care.

“Certain doctors…once the patient is ill, the doctor walks in the room they feel much better. (Patients) also feel much better when they are taken to the institution of their choice,” said Susan Baltrus, a registered nurse for 46 years and president of the Central Maine General Hospital School of Nursing. “It’s extremely important that we maintain this. Patients need that comfort in where they are going.”

But fewer than 10 percent of Anthem members are seeing primary care doctors or specialists who wouldn’t be included in the Anthem-MaineHealth plan, Colin McHugh, regional vice president for Provider Engagement and Contracting at Anthem, told the panel.

Anthem spokesman Chris Dugan said the narrower network also means that consumers will have to pay about 12 percent less than they do now. People can also choose several other plans both on and off the marketplace that would allow them to keep their doctors, he said.

“At the end of the day the subscriber needs to decide what’s important to them,” Dugan said. “We hope they choose our lower-cost products, but if the subscriber feels as through the relationship with their doctor is paramount, then there are three other plans that they can certainly purchase,” he said.

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