Heeding the complaints of thousands of Americans confused about their health plans coverage, many HMO marketers and PR practitioners will be rewriting brochures and embarking on a campaign to better educate the public about their insurance options. And at the forefront of this fog-clearing crusade is the American Association of Health Plans (AAHP).
AAHP also has encouraged its members to support a new federal rule requiring the free exchange of information between Medicare beneficiaries and their physicians. The program, which has been dubbed the Patients First initiative, even encourages physicians to discuss various treatment options with their patients regardless of health insurance restrictions.
We want to send a very clear signal that our member plans do not support any encumbrances between physician and patient in health plans, said Karen Ignagni, the president of AAHP.
AAHP, which represents abut 1,000 HMOs and other managed-care plans covering an estimated 140 million Americans, said its policy change will apply to all patients, including those covered by government programs as well as public and private sector employees.
Under the voluntary guidelines, patients who receive care in AAHP member plans will be entitled to clear information about how doctors are paid, how decisions to approve or deny treatment are made and about the coverage of prescription drugs.
The means of communication is up to the health plan, said AHHP spokesman, Don White. Some [plans] will use brochures, others television ads.
While the AHHP has not set guidelines for the media mediums its members should use for its educational campaigns, it does have guidelines for the content.
The trade group also said physicians in their plans should provide patients with a complete range of information about medical needs and treatment options, even those not covered by the plan.
Several medical organizations welcomed the announcement, including the American Medical Association, the American College of Physicians, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists and the American Association of Retired Persons.
Hopefully, the AAHP will now stop attacking necessary reforms as anti-managed care and urge their member plans to strengthen, not weaken, the patient-physician relationship, the AMA said in a statement.
The new self-policing campaign could help the AAHP balance the scales with the AMA in the debate over Medicare reform, which often has been cast as a battle between insurance companies and doctors. Ignagni rejected the notion that her group is trying to make HMOs more palatable to seniors as the debate over how to cut Medicare costs begins again.
That would be a much too cynical reading of what were doing, she said. Theres no legislative vehicle that were positioning ourselves for or against.
Ignagni said the AAHP will challenge all healthcare providers to make similar guarantees of patient rights. Were going to be talking about this in the context of the Medicare debate regarding all the players, she said.
Self-reform by HMOs could enhance weak protection of Medicare patients rights and guarantees of quality, said Edward Howard, the executive director of the Alliance for Health Reform, a bipartisan group created to expand access to health care.
You've got to admire their understanding of the political climate as well as the substance of what they announced, he said. If theres anybody whos less loved than the federal government, its the insurance industry.
(AAHP, 202/778-3200, AMA 202/822-9380)