Anyone ever done shadow care with Kaiser HMO? - Mothering Forums
Forum Jump: 
 
Thread Tools
#1 of 9 Old 08-12-2010, 01:22 PM - Thread Starter
 
msmiranda's Avatar
 
Join Date: Apr 2009
Location: Virginia
Posts: 419
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I recently switched insurance to Kaiser Permanente HMO -- meaning that I see their doctors for OB care at their facility. I haven't been yet -- and I'm not pregnant yet, so I have a lot of time to think about this stuff -- but I am wondering if anyone out there has used Kaiser for their prenatal care and then had a home birth. Here are my questions:

- Because it is not a private practice in the traditional sense, could they drop you if they knew you were planning a homebirth or would they have to continue your prenatal care? Since they are my "only choice" in terms of doctors, they could not refer me to anyone covered by my insurance, therefore would the 30 day rule apply? I would think they are not allowed to drop patients the way a doctor in a traditional private practice can -- anyone know?

- In a general way, would it be better for me just to use them as shadow care for ultrasounds, testing, etc. and then not show up for the birth? I will be paying out of pocket for my midwife. Last time I tried to do shadow care and then I stopped going after 34 weeks because I found it too stressful. I would prefer to be honest, but I don't know how Kaiser feels about liability issues. You would think that as a large organization they wouldn't be as concerned as a physician in a small practice, since I imagine that they get a pretty good deal on malpractice insurance because they are so huge.

- If I was honest about my plans and they didn't like it but weren't allowed to drop me, they would probably just lay on the dead baby stuff at every appointment, right? (Ok, I am prejudiced against OBs. So I dream up nightmare scenarios in my head and the whole thing stresses me out even though I'm not even pregnant yet).

Here's my thing: I know I will have a homebirth if I can ... but in the back of my head I think, what if I end up with a breech baby? what if I develop pre-e? what if I have placenta previa? in situations like that (I might consider breech at home, but I might not ... not sure now) I would like to have developed a relationship with someone and not be treated like a pariah at the hospital if I needed to avail myself of their services. Obviously if I had an emergent transfer there would be no avoiding that, but in the case of a complication that developed before labor ... then I think, is the likelihood of that too small to justify the hassle of shadow care? aaarrrrgggghhhh ... I think about this too much! Any wise words?

SAHM to Bird (6/07) and Bear (7/09), and now enjoying our newest additionbabyboy.gif, born June 1, 2011!  bfinfant.giffamilybed1.gifsigncirc1.gifcd.gif

msmiranda is offline  
#2 of 9 Old 08-12-2010, 01:48 PM
Banned
 
Join Date: May 2006
Location: Lost in a good book (in San Diego)
Posts: 4,819
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I have an HMO and there is one practice my medical group refers to (and PCP, med grp, and hospital are all Scripps), so I'm sort of in the same boat. I've interviewed HB midwives and one said I would just transfer care at 36 wks, but I'm with you... I want my established relationship to keep going and to just call after the birth and let them know! Just in case something developed where I needed them (and with this pregancy, enough has gone wrong that I'm no longer happy to bet that it won't!). I'm still working out how I'm going to handle it... but I do know I won't be saying anything to my OB/CNM practice until MUCH later, no matter what. I figure we'll all have a better sense of things by then-- I'll know if my sciatica has cleared up, I might have a better sense of the CNM and she might also with me-- to the point where I feel comfortable talking about it ahead of time and just saying what my plans are, but not terminating my official relationship as established with them. It really does matter-- my physical therapist, who works for the Scripps system and has that insurance, was billed for a birth where she came to the ER with the baby's head coming out and a doc saw her for one push, and then she went to materinity-- and that particular doc didn't contract with Scripps. She had to fight it. So having established care is key for me

Looking forward to BTDT responses!
St. Margaret is offline  
#3 of 9 Old 08-12-2010, 01:53 PM
 
smpayne's Avatar
 
Join Date: Oct 2009
Location: Buena Park, CA
Posts: 204
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
If the Kaiser where you are works anything like the Kaiser here, I wouldn't even worry about it. Most of the time you will see a nurse practicioner and not a doctor, even if your labled as mildly high risk. The hospital staff isn't usually the same people you see during your pregnancy.

The Kaiser here has the lowest C-section rate, highest VBAC rate and highest breastfeeding rate of all the OC hospitals. We even had a lactaion consultant on the hospital staff, she was there 3 days a week and her clinics were all covered under the HMO.
smpayne is offline  
#4 of 9 Old 08-12-2010, 02:40 PM - Thread Starter
 
msmiranda's Avatar
 
Join Date: Apr 2009
Location: Virginia
Posts: 419
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by smpayne View Post
If the Kaiser where you are works anything like the Kaiser here, I wouldn't even worry about it. Most of the time you will see a nurse practicioner and not a doctor, even if your labled as mildly high risk. The hospital staff isn't usually the same people you see during your pregnancy.

The Kaiser here has the lowest C-section rate, highest VBAC rate and highest breastfeeding rate of all the OC hospitals. We even had a lactaion consultant on the hospital staff, she was there 3 days a week and her clinics were all covered under the HMO.
I suspected that Kaiser might have lower C-section rates than private practices, since they are both the insurer and the provider, but I wasn't sure. All that is good to know!

SAHM to Bird (6/07) and Bear (7/09), and now enjoying our newest additionbabyboy.gif, born June 1, 2011!  bfinfant.giffamilybed1.gifsigncirc1.gifcd.gif

msmiranda is offline  
#5 of 9 Old 08-12-2010, 03:08 PM
 
GOPLawyer's Avatar
 
Join Date: Mar 2005
Posts: 458
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
It is my understanding that the east coast Kaiser and the west coast Kaiser are *very* different.

I went through my 2nd pregnancy & birth w/ Kaiser in NoVa and *HATED* it. Just about every.single.solitary.second of it. I actually cancelled all appointments after 37 weeks as I didn't want to deal w/ the stress. They are *very* medically oriented...completely non-crunchy. For example, I was going for a VBAC and when I met w/ a CNM, the first thing out of her mouth was, "Why don't you just schedule a c/s?" When I mentioned that I was going to a chiro a doctor actually said that it was just a bunch of hocus pocus.

I *strongly* recommend NOT mentioning homebirth at all. Not even a peep. I'm not 100% sure but I don't think that Kaiser can drop you; however, they can make appointments very hellish.

WRT breech...there are CPMs in the area that are experienced w/ breech babies. I know of one who definitely attends them and I think there's another. My wonderful, awesome, amazing CPM (I'd be happy to send you her name) just brought in the 1st CPM I mentioned if the baby ended up being breech. Breech babies can definitely be safely born at home. :-)

- Kim
GOPLawyer is offline  
#6 of 9 Old 08-12-2010, 04:31 PM - Thread Starter
 
msmiranda's Avatar
 
Join Date: Apr 2009
Location: Virginia
Posts: 419
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Wow, GOP Lawyer ... I am in your area, and yikes. So disappointed to hear they are so backwards. PMd you to talk further.

SAHM to Bird (6/07) and Bear (7/09), and now enjoying our newest additionbabyboy.gif, born June 1, 2011!  bfinfant.giffamilybed1.gifsigncirc1.gifcd.gif

msmiranda is offline  
#7 of 9 Old 08-12-2010, 09:12 PM
 
Monarchgrrl's Avatar
 
Join Date: Aug 2007
Location: San Francisco
Posts: 2,240
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I'm on the west coast, so I don't know if it's the same, but I have Kaiser HMO and it's been easy-peasy. My OB knows I'm having a home birth and she wishes I would come in more than just for a couple of ultrasounds, but she's cool with it. I'm not going in for regular prenatal appts or checks or anything. The only reason I'm even doing shadow care (if you can call it that in my situation) is for the free/cheap tests and ultrasounds. Personally, I wouldn't do it if I didn't tell them my real plans. I'm not ok with having to do prenatal appts with both practices and lying to one. But if that works for some, then that's cool.

They can't drop you. I can go in for any tests that I want and use them whenever, for whatever the midwife wants. I'm paying totally out of pocket for the midwife, but at least whatever blood tests and ultrasounds I get are free or my usual copay. It's great! If I have to transfer to the hospital for any reason, then I just show up. It's not likely I'd get my OB on call anyway. My midwife would go with us to the hospital for any reason and stay with me/us the whole time, so I'm not worried about being treated like a pariah by the staff. DW is very strong and wouldn't allow that anyway.

Good luck!!

Beth- WOHM slinggirl.gif  -Madly in love with my Wife- SAHMhola.gifandbabyf.gifSophia, born 11/2/10, at home! homebirth.jpgExpressing love, one ounce at a time!  1pump.gif

Monarchgrrl is offline  
#8 of 9 Old 08-12-2010, 09:55 PM
 
Join Date: May 2008
Posts: 1,954
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I dont think Kaiser can fire you at all, cause they will not pay for any other doctor... So you can either tell or not, whatever makes you feel better or might be less stress for you.
You can refuse whatever and they still can't do anything about it... I started with Kaiser in CA and switched at 16 weeks since my insurance changed. The private obgyn practice was way more pushy and annoying. At Kaiser I saw them for 5 minutes, nothing fancy or good, but I'd say I don't want this and done. Granted, that wasn't like refusing the GD testing or such, but you will be fine still since there is no way they can fire you.
nia82 is offline  
#9 of 9 Old 08-14-2010, 02:01 AM
 
cristeen's Avatar
 
Join Date: Jan 2007
Posts: 14,791
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Also w Kaiser in CA. For my first pg, i didnt tell them. I refused whatever tests i didnt want and when i refused the GTT, the NP "fired" me and i had to be referred to a perinatologist. They did use scare tactics, but backed off when i said it wasnt open for discussion.

For my 2nd, i was up front about it. Nobody said boo. I saw a peri once to discuss my care, and the rest of the pg just left him messages asking for this test or that paperwork. Never had a problem.

Cristeen ~ Always remembering our stillheart.gif  warrior ~ Our rainbow1284.gif  is 3, how'd that happen?!?! 

We welcomed another rainbow1284.gifstillheart.gif  warrior in May 2012!! 

2012 Decluttering challenge - 575/2012

cristeen is offline  
Reply

Quick Reply
Message:
Drag and Drop File Upload
Drag files here to attach!
Upload Progress: 0
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off