Doctors renewing contracts with LV company

Monday, March 18, 2002 | 10:57 a.m.

A Las Vegas managed care company says it has signed more than 80 percent of its doctors to contract renewals after dozens threatened to quit the network over cost increases.

But a high percentage of doctors who haven't committed are obstetricians and gynecologists who have been particularly hard hit by increases in malpractice insurance rates.

Managed Care Consultants Inc., which represents 150,000 Nevada customers who have self-insured or self-funded health-care plans, informed doctors of plans to reduce the amount it would pay for some medical procedures. Many doctors, already reeling from large increases in medical malpractice insurance, said they would quit the network unless MCC reconsidered its proposed contract.

Joe Lawrence, president of MCC, which has operated in Las Vegas since 1988, said more than 1,300 doctors have signed on to new fee schedules after his company agreed to renegotiate the terms of the contracts.

Managed care companies work similarly to insurance companies by negotiating reimbursement costs for medical procedures and paying claims for customers. Doctors benefit from the large base of clients provided by the company without having to solicit them.

Lawrence would not give details about the new contract for competitive reasons, but said his company offered concessions to doctors to convince them to sign on by an April 15 deadline.

"We've spoken with clients and doctors who are happy again and, as you can see, are rejoining our network," Lawrence said.

He said because MCC's contract renewal came at a time when doctors were receiving bad news about malpractice insurance rates, the company's request fell into "the same emotional stream."

Some Las Vegas doctors have said they may need to limit their services or see twice as many patients because of soaring malpractice insurance rates that have climbed from about $40,000 a year to $200,000 a year.

Rates began climbing in December when St. Paul Cos. stopped offering malpractice insurance because of higher jury awards. The pullout resulted in competitors raising their rates, doctors said.

Obstetricians and gynecologists were particularly hard hit by the malpractice insurance rate increase and a high percentage of OB/GYNs have not signed on to the new MCC contract. Lawrence said about 70 OB/GYNs have signed new contracts, 75 have not returned their contracts and 18 have sent termination notices.

"We're pleased that he (Lawrence) came back with an increase from the original contract," said Dr. Mark Turner, who has a private practice in Las Vegas as well as serving as the director of the Division of Gynecological Oncology and Pelvic Reconstructive Surgery at the University of Nevada School of Medicine.

Turner, who has practiced in Las Vegas for about 15 years and is among the doctors who have renewed, said many doctors already are looking to leave their practices because of malpractice insurance rates and the contract scrape with MCC was just one more issue to contend with.

"I don't know what's going on financially with them (MCC)," Turner said, "but I know a number of other companies are lowering their reimbursements so I'm sure they just wanted to test the water and see if they could lower theirs as well.

"Doctors are great at what they do, but many of them aren't particularly good businessmen and have just signed whatever these companies bring in," he said. "We can't do that anymore."