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I’m a nurse and work in one of the large hospital systems in Winston-Salem. We were provided a script because so many patients and families were calling or asking questions. We have patients in the midst of cancer treatment and if dealing with cancer is not enough now they have this. I am not an expert on reimbursement or costs but I do know health care organizations can’t survive on Medicare/Medicaid pricing. Unless you want the quality of care to equate to that of a long term care facility. Their customers are 100% Medicare/Medicaid and we all know what type of staffing, care, and environment that payment structure offers. The cost of doing business is ridiculous; we have an entire department that does nothing but deal with prior authorizations, another that deals with contracts, another that deals with denials, etc. Cutting out all the administration, paperwork, and insurance dotting “i’s” and crossing “t’s” would be a start!
I am not a state employee and I have a serious issue with this so called “health plan!” All Level One Trauma Centers would be out of network, ALL! If you are east of I95, there is only ONE, that’s it, one Level One Trauma Center for some 23 counties! Have Cancer? That’s out of network. That plan is unrealistic! When I first heard someone proclaim years ago that public education was in jeopardy, I thought surely they were paranoid and delusional. But the last decade or so has shown brick after brick crumbling. I knew I’d never be rich in this job but we were always placated by “good benefits.” Now we don’t even have them and are repeatedly talked down to. Ugh.