Last week, as part of CMA's ongoing review of physician concerns with Blue Cross of California, we reported that more than 20 percent of doctors responding to our July survey said they had or were planning to terminate their contracts with Blue Cross following the insurer's recent move to slash payments to doctors.

The survey also found:

• Out of nearly 500 practices representing 1,566 doctors and 91,000 patients in 31 counties who responded, 24 percent said they have or would terminate their contracts.
• The top three counties for planned terminations of contracts were Ventura (93 doctors), Los Angeles (86), and San Mateo (32).
• Of those physicians who said they had or were planning to cancel their contracts in response to the unilateral changes Blue Cross made to its fee schedules, primary care doctors were the top specialty, making up 11.5 percent of the total. Contrary to Blue Cross' public assertions, the changes may exacerbate the existing lack of access to primary care physicians.
• 91 percent of those who have or plan to cancel their contracts are in practices with five or fewer physicians.

Furthermore, Ventura County Medical Association (VCMA) found in its own survey just this past week that 38 doctors in that county home of Blue Cross of California have terminated their contracts. Sixty of the 169 doctors responding to VCMA's survey report difficulty referring patients to specialists such as cardiologists, pulmonologists, dermatologists, and urologists. This is troubling on many fronts, especially when you consider that Blue Cross's latest contract gives the insurer the authority to unilaterally decrease contracted payment rates if a physician refers patients to out-of-network providers.

These surveys reflect what we have feared all along. "These decreased payments are forcing some doctors to end their contracts with Blue Cross, which will reduce patients access to doctors in many areas of the state," says CMA President Anmol S. Mahal, M.D.

Contact: Jodi Black, 916/551-2863 or jblack@cmanet.org.