Obamacare Says This Company’s Insurance Rates Are TOO LOW
A Portland area clinic business, Zoom+, tried to introduce its own insurance program, and state regulators were quick to tell them that their low prices weren’t allowed under Obamacare.
Starting off as Zoom Care in 2006, the company has dozens of small, neighborhood-centric clinics, where you can often schedule an appointment on the very same day you look and waiting room times run about 5 minutes.
In 2014, ZoomCare announced that it would be getting into the insurance business. Last May, it rebranded itself as Zoom+, and announced plans for surgery, mental health services, fitness coaching, parenting specialists, brain training and dental cleaning.
The company was soon engaged in a lengthy pricing dispute with the Oregon Insurance Division. But not for the reasons you might think.
In a dispute that has few precedents in Oregon, the state insurance division argued that Zoom+’s proposed rates were too low and forced the company to increase them.
Dave Sanders, the youthful, energetic physician-turned-entrepreneur who cofounded Zoom+ with Dr. Albert DiPiero, says that this is because the state really doesn’t understand the innovation of his business model, one that uses fewer physicians and more nurses, expands the use of telemedicine and relies on a health care protocol called “Right Care” that decreases the use of unnecessary and expensive tests. In a letter of support, advocacy group OSPIRG encouraged the competition: “Zoom Health Plan, a new market entrant, is proposing a new model of health care delivery specifically intended to manage utilization and contain costs.”
But the Insurance Division suggests those rates may be too low to cover patients’ costs. “We have proposed increased rates,” says Insurance Commissioner Laura Cali, “in order for consumers to continue counting on the coverage they have purchased.” The agency declined further comment for this story.
Read the full article and complete interview with Sanders here.