Have you ever wondered why your managed care insurance company may direct you to certain places to get the care you need? Your insurance company has most likely signed a contract with these facilities to provide care to their members at a discounted rate.

Managed care insurance companies have accumulated considerable power in the marketplace. Potomac Hospital works hard to maintain contracts with area insurance providers, but in some cases, their questionable terms for new contracts and inadequate performance on existing ones leave us facing a serious dilemma.

When dealing with some managed care companies, we find ourselves in a Catch-22 situation. We must either accept the contract offered, which may mean accepting payment below the cost of the care we're providing, or revoke the contract and face the possibility of not being able to serve the people in our community who would be forced to use other hospitals. If we agree to contracts that lower our bottom line then making up the difference becomes a problem.

We don't make these decisions without a great deal of deliberation and thought. As a not-for-profit healthcare facility, we are committed to providing health care to all those who need it, regardless of their ability to pay for services. We continue to do our best to contract with all insurance companies in our market, but the limitations and cost constraints we face make our job a difficult one.

Here's what you can do to help. Before choosing an insurance plan, make sure you know its specifics, such as where you can get care. Too often, we see patients who do not know the answers to these important questions until they need care.