UPDATE (12/22/05): Just received this announcement: "Anthem Blue Cross and Blue Shield has reached an agreement with Premier Health Partners in Dayton, effective January 1, 2006." I'll have a bit more on this shortly.
Maybe; according to this article in the Dayton Daily News, Anthem and Premier “are talking at length again after nearly a year — expressing guarded optimism about the outcome.”
What’s really interesting is that the DDN story is the only source for this information, which leads me to view it with some skepticism. That’s not to say that it couldn’t happen, but if substantive negotiations were taking place, one would expect to see multiple “leaks.” After all, these are the two largest players in the local health care market, and any forward movement in their tempestuous relationship would be newsworthy.
Of course, even if it is true, cautious optimism is in order:
“(F)rom the perspective of members, I'd hate to get somebody's hopes up," Anthem spokeswoman Kim Ashley warned. "We do not have a definitive, signed agreement."
On the other hand, Premier may want to reconsider reconsidering:
“Doctors say that Anthem…made an arbitrary change in company policy that means physicians are being underpaid for some services rendered.
The change…put into effect Nov. 1 is shortchanging doctors about $25 for each of certain types of office visits when additional services are provided to patients.”
According to the physicians, Anthem now "blends" (whatever that means) codes for different services in order to arrive at a lower reimbursement level. Anthem claims that this new method will actually increase how much they'll pay out.
I know which way I’d bet.
UPDATE (12/21/05): According to my Anthem sales rep, negotiation is ongoing. As noted above, however, there has been no resolution. Interesting.