Black doctors get hearing on HMO concerns

Friday, October 16, 1998

The Cincinnati Enquirer

The issue of African-American doctors being dropped or excluded from managed care health plans will get public hearings next week before health committees at the city and state level.

Concerns raised Thursday at a press conference held by the Cincinnati Medical Association drew promises from several black politicians and Cincinnati Mayor Roxanne Qualls to investigate the issue.

State Sen. Janet Howard, vice chairwoman of a state health committee, said she will bring the issue up at a Monday hearing in Columbus. Meanwhile, Cincinnati council member Minette Cooper pledged to raise the issue at a city health committee meeting on Tuesday.

Black doctors say managed care business decisions to work with large groups of doctors and rate physicians based on costs and patient volume tend to hurt black doctors more than their white colleagues. The issue has been simmering nationally in recent years as HMOs have moved into Medicaid and Medicare, long time areas of concentration for black physicians.

It has peaked now in Cincinnati because Anthem Blue Cross and Blue Shield recently decided to drop two highly respected black orthopedic surgeons from its most popular health plans.

Anthem officials on Thursday said the company does not ask the race of its member physicians, adding that it could be accused of racial discrimination if it did.

"When a reduction in network size becomes necessary, all available data is carefully analyzed . . . "

Anthem officials said in a prepared statement. "However, Anthem does not contemplate cultural diversity when making network refinements - provider terminations because so doing could be viewed as a discriminatory act."

State Rep. Sam Britton called Anthem's response "a lame excuse."

"Anthem seems to be on the wrong track," Mr. Britton said. "First, they tried to eliminate tens of thousands of senior citizens in rural districts of Ohio from their plan. They were brought to task for that and things have changed. Now we have to do the same thing."

Dr. Camille Graham, president of the Cincinnati Medical Association, said employers and insurers need to make sure their health plans include at least some black doctors.

"I don't think any white corporate executive would sign up for a health plan that had all black doctors and charged extra to see a white doctor," Dr. Graham said. "It isn't fair to expect African Americans to pay more to see a black doctor."

Ms. Cooper said concerns about Anthem dropping black doctors are particularly important to the city because Anthem provides the city employee health plans and many city employees are black.

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