Thousands of employers in California and across the country are slashing expensive doctors and hospitals from their insurance rosters in a move to hold down rising healthcare costs — a trend that is gaining favor with corporate bosses, if not the rank and file.
The savings on insurance premiums — nearly 25% in some cases — are gained when companies switch their health plans to "narrow network" HMOs that offer fewer choices of medical providers.
California, with nearly 21 million people in health maintenance organizations, is driving the rapid expansion of these networks. More than 10,000 California employers and public agencies have enrolled, mostly since the recession struck in 2008.
While many workers welcome the cheaper HMOs, the savings come at the price of fewer healthcare choices.
Beverly Prange chose a slimmed-down network in January offered through her employer, the San Diego County Office of Education. The change cut her insurance premiums but meant switching physicians, something she was reluctant to do.
"I have less flexibility now than I had in the past," said Prange, a migrant education specialist. "I liked the doctor where I was."
The narrow networks have attracted some of California's largest employers. Two of the biggest users — the University of California and the California Public Employees' Retirement System — have offered their members the option of slimmer plans sold by Health Net Inc. and Blue Shield of California, and say the cost-cutting alternatives have found wide acceptance.
"It's a better use of healthcare dollars for our members," said Kathleen Billingsley, a CalPERS benefits official.
Insurers and employer groups say the networks have grown fastest among small businesses, allowing them to save money and still get high-quality medical care for their employees.
California Furniture Galleries, a small home furnishings store in Canoga Park, chose the "Silver" network from Health Net last year rather than asking 14 employees to pay more for their health insurance. The change roughly cut in half an expected 13% increase in premiums, and most employees were able to keep their doctors, who were part of the smaller network.
"It was a no-brainer," manager Mike Katz said of the decision to switch.
The availability of doctors varies by each narrow network. Woodland Hills-based Health Net, one of the first to promote the strategy in California, features 47,000 doctors in its full HMO network but just 7,000 physicians in its Silver plan.
That network — available in 10 counties, including Los Angeles, Orange, San Bernardino and Riverside — can save businesses as much as 14% on insurance premiums, a spokesman said.
An even smaller network, Bronze, has 1,600 doctors in Los Angeles, San Diego and San Bernardino counties, and can shave as much as 24% off insurance bills.
"We know we have a popular, growing concept," said Health Net spokesman Brad Kieffer, who noted the company's plans to expand beyond California.
Other insurance companies, seeing a trend in the making, are eagerly promoting their own versions of narrow networks nationwide. Three of the largest national providers in particular — WellPoint Inc., Aetna Inc. and UnitedHealth Group Inc. — are quickly expanding the niche to capture millions of new customers.
UnitedHealthcare alone has signed up about 75,000 employer groups nationwide, the bulk of them in the last two years, including more than two dozen Southern California school districts that joined in January.
"We are revving up that engine," said Dr. Sam Ho, UnitedHealthcare's chief medical officer. "There is an aggressive appetite for new solutions and new opportunities to manage healthcare costs."
California regulators said consumers were protected from potential abuses by a state law that requires narrow networks to abide by the same rules set for broader HMO systems — for example, providing access to doctors and hospitals close to patients' homes.
Healthcare experts and consumer advocates warn that eliminating doctors and hospitals from insurance lists could harm patients, particularly those who depend on specific providers to treat chronic or life-threatening conditions.
Buy fashion Supra Shoes in a lowest price in cheapsupratkshoes.com, which guarantees you with lowest price buying best and latest supra skytop shoes, supra footwears and Supra Society,cheap Supra Skytop is a fashion style with top quality, and with free shipping.Billy Joel is keeping his life story to himself.
Three years after inking a $3 million deal with HarperCollins to release a memoir, The Book of Joel, this June, the Piano Man has called the whole thing off and plans to return the advance he already received for his efforts.
Sure, sometimes a celeb has second thoughts after realizing what a daunting task it is to write a book. But the Rock and Roll Hall of Famer's book was already done, so why the about-face?
MORE: Good news! Billy Joel doesn't want to punch Elton John in the face
"It took working on writing a book to make me realize that I'm not all that interested in talking about the past, and that the best expression of my life and its ups and downs has been and remains my music," Joel said in a statement Thursday.
Which, of course, leads us to wonder what exactly about the past—the three marriages, the substance-abuse issues, the money troubles, his daughter's recent struggles, Elton John's very public remarks about his friend's condition?—prompted the six-time Grammy winner to stop the first printing (a reported 250,000 copies) in its tracks.
Or perhaps Joel simply just didn't like how he came off after the memoir was edited into the "emotional ride" promised by his publisher in publicity materials.
So instead of joining Bob Dylan, Eric Clapton, Patti Smith and Keith Richards in the annals of musicians who can rock a page as hard as they do a stage, Joel is keeping company with Mick Jagger. The Rolling Stones frontman pulled out of a book deal in the 1980s and said last year after Richards' Life made a splash that he found it "really quite tedious raking over the past."
He said a total of 29.7 million trips were undertaken during the year, compared with 30.3 million in 2009.
It was interesting to note that for the first time in many years, travel to visit friends and relatives declined as a share of the total trips undertaken, he said.
For 74% of all trips undertaken, the primary purpose was still visiting friends and family, but this did decrease slightly from 76% in 2009.
Van Schalkwyk said it was encouraging to note that holiday travel had increased from 12% of all trips taken to 13%.
Domestic tourism has historically been, and remains, the largest contributor to tourist volume in South Africa, with 79% of all volume in 2010 derived from domestic tourists.
According to Van Schalkwyk, for the first time in many years there had been increases in key areas such as frequency, overall spend and the length of stay.
He said it was evident that marginally fewer South Africans travelled in 2010, but he believed the increases in spending and regularity of travel showed that South Africans were embracing a culture of travel.
Van Schalkwyk launched SA Tourism's new Sho't Left campaign for 2011-12.
Sho't Left, with a R30-million investment, encourages all South Africans to explore their country and showcases it as a fun, affordable and easy-to-travel destination.
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