Recently, the California Department of Managed Care has released some new guidelines for HMO patients, in order to create a more efficient and comprehensive level of care for these patients. Among the new rules:
• A physician appointment within 10 business days of a request
• A specialist appointment within 15 business days of a request
• An urgent care visit within 48 hours of a request
• Telephone access to a health care professional at all times.
The state is giving health plans one year to comply with these new regulations. After the one year grace period, non-compliant carriers will face heavy fines. With the implementation of these new rules, it is hoped to reduce emergency room traffic, as more patients are able to obtain urgent care visits instead, as well as the overall reduction of appointment wait times (which benefit all patients – HMO and PPO alike).
Opponents to these new regulations feel that this adds to an already strained system of primary care physicans, who are already in shortage. Fears also lie in the fact that the doctor would now be forced to spend less time with each patient. However, with the average waiting time to see a general practitioner at 20 days, it does seem that the pros outweigh the cons with these timely-access rules.
