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Physicians group threaten quota system for ACA patients


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.

These clinicians too busy to add telemedicine



Clinicians in the behavioral-health departments at Children’s Mercy Hospitals and Clinics, in Kansas City, Mo., are pushing back against pressures from theIR C-Suite to make more use of telemedicine. The clinicians say that they’re too busy to take on what they think 0f as added work.

But meanwhole, 1DocWay, a psychiatric telemedicine startup, has raised $1.7 million more to expand its business to 10 states from 7.




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