Appears that the exclusivity clause in the contract may have created several unanticipated problems such as:
This would mean that a patient, who may need cardiac or maternity care, may need to drive 50 miles and pass 4 or 5 good hospitals in the plan in order to get the care they needed at Verde Greene Hospital.
A number of Obstetrics and Gynecology as well as Cardiologists who reside in one of the 14 counties do not have privileges at Verde Greene Hospital, and have threatened to dis-enroll from the plan if Verde Greene Hospital is the only hospital contracted to see their patients. Even if these physicians were given hospital privileges, this would mean more staff meetings and Emergency Department duty, at a hospital that is too far away. These physicians have threatened to dis-enroll from the plan. The existing staff physicians at Verde Greene Hospital objected to the loss of available hospital space and time, as well as, the possibility of the loss of existing patients to the new physicians. These physicians threatened to dis-enroll from the plan.
The other hospitals in the managed care plan objected to the loss of patients and threatened to dis-enroll from the plan, and to sue for restraint of trade.
Your Assignment
What should the ABC Insurance Company do? Why? How?
What should Verde Greene Hospital do? Why?
What should the employers do? Why? How?
What should the patients do? Why? How?