Monday, February 28, 2005

Anthem and Premier Have a Food Fight…

Okay, not really, but I couldn’t resist the headline. What did happen, tho, is that the much-ballyhooed arbitration has come to an abrupt – and fruitless – halt. Apparently, after they had met for a grueling day and a half (not counting coffee- or potty-breaks), the two sides “broke off their mediated negotiations without a contract.”
Where does this leave those Anthem insureds whose providers are in the Premier system? Think creek, missing paddle. For most, non-emergency access to Premier services will come with a much higher price tag. For some, there may be no non-emergency coverage at all (this depends on which plan design a given insured has chosen).
As always, there are (at least) two sides to this story. Anthem maintains, and Premier has so far not disputed, that Premier’s costs are significantly higher than other, comparable area provider networks. In essence, Anthem insureds who choose non-Premier providers are subsidizing those who do utilize Premier. OTOH, physicians and hospitals do have costs, and Premier, in the form of Miami Valley hospital, runs the region’s CareFlight service. That can’t come cheap.
So, at least for now, this will continue to be a juggling act between offering affordable health insurance (often, Anthem’s rates are below-market) versus access to a LOT of providers.
There don’t seem to be any winners here.
blog comments powered by Disqus