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John Krah

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Physicians group threaten quota system for ACA patients

highmark

Highmark headquarters in downtown Pittsburgh.

The Pittsburgh-Tribune Review reports that Highmark Inc. will cut payments to physicians by 4.5 percent starting April 1 after a $500 million loss last year on  Highmark insurance plans sold on the Affordable Care Act marketplace.

Highmark officials say that the people who signed up through the ACA’S marketplace were sicker than the insurer expected.

But John Krah, executive director of the Allegheny County Medical Society, said physicians shouldn’t be held responsible for Highmark setting plan costs too low to cover care.

He said that  doctors might end up setting quotas for how many of the ACA-linked patients they would accept at their practices,  as they do for Medicare and Medicaid patients.


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