Here are four notes:
1. According to Highmark, it lost $500 million last year from plans purchased on the PPACA marketplace. Thus, starting on April 1, doctors’ payments will be cut by 4.5 percent.
2. PAFP is fighting against the decision. PAFP President Nicole Davis, MD, calls Highmark’s move “profoundly disappointing,” especially as the group maintains Highmark has several billion dollars in reserves.
3. Highmark is involved in patient-centered medical homes, improving patient outcomes and avoiding hospitalization, which makes the announcement even more concerning for physicians in the state.
4. Dr. Davis also urges the Pennsylvania Insurance Department to ensure the viability of PPACA marketplace plans without negatively impacting participating physicians.
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