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Insurance: The Gateway or Roadblock to Care

 

This page offers MCC's research on the difficulties women face obtaining insurance and our report on medical malpractice.  MCC also checks which Medicaid plans are accepted at local birth centers and hospitals in Bucks, Chester, Delaware, Montgomery, and Philadelphia counties. 

           

Medicaid Insurance Accepted by Regional Maternity Unit

The Department of Public Welfare funds five Managed Care Organizations (MCOs) to serve Medicaid eligible families.  These MCOs are: HealthPartners (HP), Keystone Mercy (KM), AmeriChoice (AC) and the two new Medicaid plans, Aetna Better Health (AE) and CoventryCares (CC). Below is a chart showing which MA plans are accepted at local hospitals.  Generally, women make prenatal visits and give birth at a facility that has a contract with their healthcare plan. In emergency situations no one is turned away because of their insurance plan, or lack of insurance. 

Hospitals are not required to accept all insurance plans so pregnant women may have to change providers or their insurance plans.  Adding to the confusion, individual doctors within a hospital may not accept the same plans as the hospital.  We investigate what options women have based on their insurance.  To eliminate confusion and ensure care for all women regardless of income, all non-profit hospitals and providers associated with them should accept all Medicaid health plans.

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Bucks County

HOSPITAL

MCO ACCEPTED

2007
2008
2010
Doylestown Hospital
HP, KM
KM, AC
KM
Grand View Hospital
HP, KM
KM
KM
Lower Bucks Hospital
HP, KM
HP, KM, AC
HP, KM, AC, AE
St. Mary Medical Center
HP, KM, AC
HP, KM, AC
HP, KM, AC, AE, CC

Table Key: HealthPartners (HP), Keystone Mercy (KM), AmeriChoice (AC), Aetna Better Health (AE), Coventry Cares (CC)

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Chester County

HOSPITAL
MCO ACCEPTED
2007
2008
2010
Brandywine Hospital HP, KM, AC HP, KM, AC HP, KM, AC
Chester County Hospital HP, KM KM, AC AC, AE
Jennersville Regional Hospital HP, KM HP, KM HP, KM
Paoli Hospital  KM KM KM, AE, CC
Phoenixville Hospital KM KM KM

Table Key: HealthPartners (HP), Keystone Mercy (KM), AmeriChoice (AC), Aetna Better Health (AE), Coventry Cares (CC)

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Delaware County

HOSPITAL
MCO ACCEPTED
2007
2008
2010
Crozer-Chester Medical Center KM HP, KM KM
Delaware County Memorial Hospital KM HP, KM KM, CC
Riddle Memorial Hospital KM KM KM, AE, CC

Table Key: HealthPartners (HP), Keystone Mercy (KM), AmeriChoice (AC), Aetna Better Health (AE), Coventry Cares (CC)

 

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Montgomery County

HOSPITAL
MCO ACCEPTED
2007
2008
2010
Abington Memorial Hospital HP, KM HP, KM HP, KM, AE
Bryn Mawr Hospital KM KM KM, AE, CC
Central Montgomery Medical Center HP, KM, AC HP, KM, AC CLOSED*
Holy Redeemer Health System  HP HP HP
Lankenau Hospital KM KM KM, AE, CC
Mercy Suburban Hospital      HP, KM, AC HP, KM, AC CLOSED*
Montgomery Hospital Medical Center HP, KM, AC HP, KM, AC HP, KM, AC, AE
Pottstown Memorial Medical Center HP, KM, AC HP, AC HP, KM, AC

Table Key: HealthPartners (HP), Keystone Mercy (KM), AmeriChoice (AC), Aetna Better Health (AE), Coventry Cares (CC)

*Maternity unit is closed, hospital is still open.

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Philadelphia County           

HOSPITAL
MCO ACCEPTED
2007
2008
2010
Albert Einstein Medical Center HP, KM HP, KM HP, KM, AC, AE, CC
Chestnut Hill HealthCare HP, KM, AC CLOSED* CLOSED*
Hahnemann University Hospital HP, KM, AC HP, KM, AC HP, KM, AC

Hospital of the University of PA

HP, KM, AC HP, KM, AC HP, KM, AC, AE
Pennsylvania Hospital      HP, KM, AC HP, KM HP, KM, AC, AE
Temple East-Northeastern Hospital HP, KM, AC CLOSED* CLOSED*
Temple University Hospital   HP, KM, AC HP, KM, AC HP, KM, AC

Thomas Jefferson University Hospital

KM KM KM, AE, CC

Table Key: HealthPartners (HP), Keystone Mercy (KM), AmeriChoice (AC), Aetna Better Health (AE), Coventry Cares (CC)

*Maternity unit is closed, hospital is still open.

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Birth Centers     

HOSPITAL
MCO ACCEPTED
2007
2008
2010

Bryn Mawr Birth Center

KM KM KM
Valley Birthplace & Woman Care KM KM KM, AC

Table Key: HealthPartners (HP), Keystone Mercy (KM), AmeriChoice (AC), Aetna Better Health (AE), Coventry Cares (CC)

 


 

  

Our Insuring Health Births Report Arrived Mother's Day 2009!

Read the report online!

Insuring Healthy Births reviews the healthcare services  childbearing women need and the kinds of health insurance currently available in our state. The changes offered in this report will increase access to safe, quality maternity services in all of PA- there's no better gift for moms!

Supplemental information:

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Medical Malpractice & the Maternity Crisis Report

Medical Malpractice & the Maternity Crisis: Is there a connection? This paper explores the link often made in public debates between the high costs of medical malpractice for providers and the growing maternity crisis. MCC finds little evidence that these costs are the cause of the crisis. MCC'S Childbirth at a Crossroads report offers recommendations on reversing this trend. 

 

Please visit our Childbirth Crisis News page to read recent articles or Take Action on important issues!

 

 

 

Last Updated August 2010

 


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