TAMPA — A national survey suggests that the country’s top cancer centers are off limits to many of the insurance policies being offered under the Affordable Care Act. Fortunately for Tampa area patients, that’s not necessarily the case, with the H. Lee Moffitt Cancer Center and Research Institute included in the networks of most major providers in the region’s insurance marketplace.
The Associated Press this week surveyed institutions that are part of the National Comprehensive Cancer Network, considered the leading hospitals with the latest clinical research and knowledge and a multidisciplinary approach to patient care. Moffitt is one of those hospitals.
The AP said only four of 19 hospitals that responded said patients have access through all the insurance companies in their state exchange.
Locally, patients do not have access to Moffitt through all plans offered here. But of the six leading providers, Cigna, Coventry One, Florida Blue and Florida Blue HMO offer plans with Moffitt in a network. Humana and Aetna do not, although Aetna has acquired Coventry Health Care and offers such policies under that label.
Lack of access to a National Comprehensive Cancer Network facility could mean that a patient doesn’t receive the most advanced treatment, including clinical trials of new drugs.
“It’s important for patents to find out if their favorite doctor, their favorite facility, is included in the health plan before they purchase it,” said Michael Holtz, regional director for the American Cancer Society’s Cancer Action Network.
Jodi Ray, project director for Florida Covering Kids and Families, one of the key “navigator” organizations guiding people through the ACA process, said she couldn’t speculate on insurers’ strategy, but added, “I’m glad that the folks here are not running into that situation” where Moffitt is off-limits.
Insurers can design narrow networks of hospitals and doctors to keep premiums low. A spokesman for Humana said enrollees have access to oncology services provided by Tampa General Hospital, Bayfront Medical Center and other hospitals.
“Humana has designed its exchange provider networks in Tampa Bay and other Florida markets to offer health care consumers access and affordability, and that may mean fewer choices of specialists and providers,” said spokesman Mitchell Lubitz.
Mark Slitt of Cigna, which has Moffitt in its plans, said his company offers a “fairly broad network” for its exchange plans in Florida. “Every plan makes their own decisions about how they structure their network,” Slitt said. “We focus on quality.”
The Associated Press cited situations such as Houston, where the MD Anderson Cancer Center said it was in less than half the plans offered in that area; New York City, where Memorial Sloan-Kettering is included in policies offered by two of nine insurers; and Seattle, where the Seattle Cancer Care Alliance is excluded by five out of eight insurers.
“The challenges of this are going to become evident … as cancer cases start to arrive,” Norman Hubbard, executive vice president of the Seattle alliance, told the AP.