Bespoke San Diego Medical Group to terminate Medicare Advantage

Scripps Clinic was the place I got my medical care when I lived in beachfront town just North of San Diego in the late 1980’s. They actually cut a golf ball sized brain tumor out of my head in 1988. The only bill I remember was a $2 co-pay for prescription-strength Advil. Everything else was covered 100% with no deductible. Health insurance was very different back then.

{{ Scripps Clinic and Scripps Coastal are highly rated by patients, according to health care report cards by the California Office of the Patient Advocate.

Their reputation, said Nathan Kaufman, a health care consultant based in San Diego County, makes them sought after across the region.

“Scripps Coastal is, I would say, a premier primary care network and Scripps Clinic is one of the premier multi-specialty groups in the market,” Kaufman said.

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“Many providers who sign a contract with a Medicare Advantage plan that say they will get paid at the Medicare rate actually end up getting paid worse than Medicare,” Kaufman said.

Scrutinizing reports from the U.S. Centers for Medicare and Medicaid Services, Kaufman said that reported profit margins for advantage plans have been slim. These reports, he said, have lately shown that many plans only reach profitability because they receive significant rebates on prescription drugs.

“If you don’t get huge pharmacy rebates, the likelihood is that you’re going to lose a lot of money,” Kaufman said. }}

You’re skimming 15% off the top, and you still need to price gouge on prescription drugs to make any money? This excessive Executive Compensation is really getting out of hand. {{ LOL }}