HMOs right to terminate doctors at will may have bigger impact on behavior of physicians than gag clauses, GAO concludes
Back Page Briefs
October 31, 1997
WASHINGTON—A General Accounting Office review of 1,150 physician contracts from 529 HMOs concludes that the "at will" termination clauses contained in the majority of contracts may exert greater influence on doctors than any language that could be interpreted as a "gag clause."
Some 72% of the contracts reviewed by the GAO allow an HMO "to terminate its contract with a physician without having to specify a reason, generally with a notice period of 30,60, or 90 days."
While the HMO industry considers the clause a necessity to ensure high-quality medical care, the GAO noted that many physicians believe it provides "an incentive for physicians to comply with restrictions on patient communication," especially "in regions where the health care marketplace is dominated by a few large managed care plans."
The GAO found no "contract clauses that specifically restricted physicians from discussing all appropriate medical options with their patients." Some 60% of the contracts "had a nondisparagement, nonsolicitation, or confidentiality clause" that some doctors might interpret as a gag clause. But, the majority of these clauses contained language making it clear that the HMO was not attempting to restrict a doctor’s ability to give medical advice to patients, the GAO said.
Copies of the report, "Explicit Gag Clauses Not Found in HMO Contracts, But Physician Concerns Remain (GAO/HEHS-97-175) are available on the Internet at http://www.gao.gov or by calling 202-512-6000.
GAO says HHS must do better job of evaluating rural access programs
WASHINGTON—A new General Accounting Office report blames the federal government’s "flawed systems for measuring health care shortages" as a key reason the Rural Health Clinic program and other programs have failed to appreciably improve access to medical services for most people.
According to the GAO, the Department of Health and Human Services (HHS) does not have a way "to effectively match the various programs with the specific kinds of access problems that exist." As a result, it notes, "federal programs placing providers in underserved areas have oversupplied some communities and states with providers, while others received none." Copies of the report, "Opportunities to Target Programs and Improve Accountability (GAO/T-HEHS-97-204) are available at http://www.gao.gov.
HMOs right to terminate doctors at will may have bigger impact on behavior of physicians than gag clauses, GAO concludes
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