WASHINGTON — Cancer patients relieved that they can get insurance coverage because of the new health care law may be disappointed to learn that some of the nation’s best cancer hospitals are off-limits.
An Associated Press survey found examples coast to coast. Seattle Cancer Care Alliance is excluded by five out of eight insurers in Washington state’s insurance exchange. MD Anderson Cancer Center says it’s in less than half of the plans in the Houston area. Memorial Sloan-Kettering is included by two of nine insurers in New York City and has out-of-network agreements with two more.
Doctors and administrators say they’re concerned. So are some state insurance regulators.
In all, only four of 19 nationally recognized comprehensive cancer centers that responded to AP’s survey said patients have access through all the insurance companies in their state exchange.
Not too long ago, insurance companies would have been vying to offer access to renowned cancer centers, said Dan Mendelson, CEO of the market research firm Avalere Health. Now the focus is on costs.
“This is a marked deterioration of access to the premier cancer centers for people who are signing up for these plans,” Mendelson said.
Those patients may not be able get the most advanced treatment, including clinical trials of new medications.
http://nypost.com/2014/03/19/nations...der-obamacare/The AP asked the centers how many insurance companies in their state’s exchange included them as a network provider.
Of the 19 that responded, four reported access through all insurers: the Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore; Fox Chase Cancer Center in Philadelphia; Duke Cancer Institute in Durham, NC; and Vanderbilt-Ingram Cancer Center in Nashville, Tenn. One caveat: Some insurers did not include these cancer centers on certain low-cost plans.
Two centers have special circumstances. The best known is St. Jude’s Children’s Research Hospital in Memphis, Tenn. Treatment there is free as long as children have a referral.
For the remaining 13, the gaps are evident.
In Buffalo, NY, Roswell Park Cancer Institute is included by five of seven insurers in its region. But statewide, the picture is much different: Roswell Park is not included by 11 of 16 insurers. Dr. Willie Underwood, associate professor of surgical oncology at the teaching hospital, says that’s a problem.
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