Coverage for example in one market where we are the narrower provider we found they had no access to pet scans. Another glitch we found as their exclusive Network Provider they had not contracted with any Lamp Services or radiation therapy. We can provide these services but frankly getting Outpatient Lab testing at your hospital may not be as convenient as some of the labs that are available with better parking and hours. Finally id like to reemphasize the reality of the marketplace is that price dominates. Premiums is what people are most likely to look at. Those with low income still leave outofpocket medical expenses that are unaffordable below this operation. As a result, even modest out pocket costs create affordability programs. This is from one of our markets. A married couple. Income 48,000 a year. They chose a bronze plan. Their premium is subsidized. They have a 3,600 deductible and a 12,000 potential outofpocket maximum. If one of this group needed a jant re placement or hth
That somebody can be get to in tough numbers and types in a reasonable amount of team states can look at the networks to make sure that that definition of reasonable is reasonable. When you look at the time it takes people to get to them, any waiting periods, any distance issues that you make sure that everybody can get to somebody in a sufficient way. If not, if there is an insufficient network the carrier makes sure the patient can go to another doctor or provider and that they would be not charged more for going to them. They require the carriers to file an access plan with the commissioner prior to offering the new managed care plan. What goes in that is a description of the network and also say how they are going to monitor the network on an ongoing basis. What their egregious procedures will be if somebody has a problem or question about the network. Notification. How do they notify if theres a change. Also, the continuity of care if somebody is dropped how are you going to make
Regulate and have transparency for limited network plans. Because they are and im familiar with some anecdotes where say in ophthalmology, which i know fairly well where the issue about retina specialists was raised. And, you know, through the academy of ophthalmology went to the insurer who i think just responded. Oh, we didnt know that. So we will make sure to put some retina specialists in the plan. So i think its just discovery that this is an issue. And i would say yes, you know, the detail that is going to be needed in some specialties will probably have to go by sub specialty. And it is going to make it more complex but this is going to be a big part of our market environment. So we mights well ju as well ju that. Anybody else . Brian. It does vary by state. But some do a deep dive and they go down to specialists, subspecialists. Not at medicare venues though. We dont get to regulate that. So were excluded. Yes, go right ahead. I work with the American College of nurse mid wives
My b. A. In Child Development and im currently at the university of San Francisco pursuing a degree in organization and leadership and education. My vision for this new office which im really anointed about, the 9 seats that will be represented are critical in sort of creating a system or strengthening the system to continue to work on the strengths and successes that weve had over the years, leverage our resources, San Francisco is rich with resources so we have to continue to find out how to leverage those so obacker our families can benefit, increased access, particularly for children with special needs, nrs a focus on continuity of care, a lot of the children that are in my program that have special needs, we figure out by leveraging other resources and funding to continue to provide those services to our children so they can benefit from the continuity of care who we know its important for these people. Breaking the silos among city departments and aligning our vision, we can str
Im honored to be considered as a mayoral appointee to the new citizens advise have i Committee Seat 4 representing philanthropy, currently serve as Program Director [inaudible] our sole mission at the foundation is to increase access to high quality Early Education for San Francisco lowincome children and families. Since our inception in the 80s, the foundation sought to work in partnership with providers, with families, with the School District and with the city to create high quality system of care for children and families. Just briefly, my work at the foundations fathers a decade of public service. I had the challenge of serving as the director of policy and planning and being one of their early Human Service coordinators for them mayor newsoms initiative. [inaudible]. I would say its notable for this convening that hoover the most exciting and flourishing parts of my career, i founded the child care facilitys fund during welfare reform and under my tenure, we created 12 new state