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Secure Horizons Facing Revolt in Massachusetts Health Care

September 06, 2000|Dow Jones

As in other areas of the country, growing pressure on health plans for seniors could lead to higher premiums and other unwanted changes for Massachusetts residents enrolled in the Secure Horizons plan.

Secure Horizons, operated by PacifiCare Health Systems Inc. in Santa Ana, is the largest health maintenance organization for Medicare patients in Massachusetts.

Hospitals and doctors' groups say they are losing money treating Secure Horizons patients. So in pending contract talks to set the terms for 2001, the health care providers will be demanding higher payments from PacifiCare.

Several small hospitals have told the plan they will stop treating Secure Horizons patients Jan. 1. Larger hospitals are threatening to do the same. Some see the stance as negotiating ploy, but the HMO says as many as 25,000 people could be affected.

For seniors, the upshot is likely to be costlier benefits, says Steven Tringale, a managing partner at Hinckley, Allen & Tringale, a Boston health care consultant that represents some of the hospitals involved the talks.

Plan executives say cuts in federal Medicare reimbursement have made the Secure Horizons product less profitable. But they say they expect the product to remain profitable next year and expect profits in other business lines.

PacifiCare stock fell $1.69 to close at $52.94 a share in Nasdaq trading.

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