Rebellion in White: Doctors Pulling Out Of H.M.O. Systems
Growing numbers of doctors in New York, particularly those serving upper-middle-class patients, are dropping out of managed care plans with lowest reimbursement rates or biggest administrative headaches; others are looking for alternative ways to negotiate with HMO's, like forming group practices or other professional associations that have more leverage to seek better reimbursement rates; hospitals are asking New York State Attorney General's office to look into managed-care company practices; there are signs that movement extends past New York City's borders: Summit Medical Group, in Summit, NJ, with 100 doctors, just dropped Blue Cross; Dr Greg Sachs, president of Medical Society of NJ, says he expects more doctors to quit HMO's; patients whose doctors leave managed care plans have option of paying themselves or finding another doctor; some health care experts are predicting that tiered health care system is in offing as result; as long as employers continue to offer plans that give employees chance to go to doctors outside their networks, and HMO's continue to push doctors to cut costs, more are likely to leave HMO's; photo (L)
