Working Together to Provide Choice
November 22, 2016
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David Dick
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By: David Dick, HRMC President & CEO
A new year typically brings new changes to insurance plans. Beginning January 1, 2017, South Dakota will see several of its health insurance plans change rapidly. Will health care transform to offer fewer choices for rural citizens? There certainly appears to be a plan to transform the industry to control both the quality, through a narrow network of providers, and the cost.
Entering into 2017, enrollees will have to pay more attention when choosing a healthcare facility or physician for their care. Narrow networks, or provider-owned health plans, are designed to keep the cost of premiums manageable by utilizing a closed healthcare system of providers. DAKOTACARE was the first to experience a change in their list of contracted providers when Sanford decided to no longer have a provider contract after Avera’s purchase of DAKOTACARE. This was followed shortly by a similar decision made by both systems regarding Sanford Health Plans and Avera Health Plans. How will this change impact rural citizens in our region if they are insured by one of these plans?
HRMC, in its commitment to our mission, is an in-network facility to Sanford Health Plan, Avera Health Plan and DAKOTACARE. We will continue to be the healthcare home for the vast range of specialty care regardless who employs the physician.
It is the blessing of our private 501 (c) nonprofit status with a local governance structure to be able to bring an array of specialty knowledge to support our local physicians while working together to improve the health of our community. Even with this commitment on our part, your health plan might not recognize a visiting specialty physician as in-network. So, it is important to understand your health plan as we enter into 2017.
I remember a West River rancher telling me at coffee one day, “the only thing money does is give you more choices – that’s good if you are making good choices and bad if you are making bad ones.” Less choices doesn’t have to mean poor choices. For rural citizens, it will mean we will have to work together even more to make it the best choice possible.
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