Please excuse my French. It's the start of a famous quote: The more things change, the more they stay the same.
Or, as Yogi Berra once observed: It's deja vu all over again.
Our readers may recall that not so long ago, Anthem and a local group of providers had a falling out, with predictably (at least by us) problematic results. Claims went unpaid, or reimbursed at drastically reduced levels, checks were cut to insureds instead of providers, there were daily diatribes in the local press (some pro-Anthem, others pro-Premier).
In short, it was ugly (if you don't believe me, just do a search here on "Premier").
Maybe there's something in the southwest Ohio air (or water), but it appears that an eerily similar brouhaha is shaping up in the Cincinnati market. There, the big player is the Cincinnati Health Alliance, comprising some 8 hospital networks and who knows how many physicians. Reading the press is weird: it sounds like a rerun of the Anthem-Premier grudge-match. The carrier claims that the Alliance's demands are out of reason, while the providers aver that Anthem is playing hard ball with their patients' care.
Sound familiar?
Fortunately, I have access to top secret materials (not really: these are flyers sent out by the providers, pleading their case) that may shed some light on the matter.
For Anthem's part, they claim that the Alliance is already overpaid, and that meeting their new demands would be unfair to premium payors and other providers.
Of course, we all know who really ends up with the short end, right?
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