Monday, February 21, 2005

Brooklyn Bridge For Sale…

According to the Dayton Business Journal, “Anthem expects to save $40 million to $50 million this year as a result of dropping Premier from its network,” and “plans to funnel some of that savings back to businesses through quarterly premium credits.”

Leaving aside the plausibility of ANY insurer promising to “reduce rates,” nowhere in the article does the company representative [ed: Chris is an okay guy. This isn’t a slam on him, per se] explicate exactly how Anthem determined that it would save this amount of money by deleting Premier from its network.

But it gets better: these “premium credits” would only be available to groups of greater than 50 employees. The major problem here is that most employers fall into that “small group” (under 50 lives) category, and so will never see a penny in “savings.”

Notice the other “gotcha,” as well: those employers which ARE eligible will see that any savings will be offset (reduced) “based on how often their employees had used Premier services in the past.”

So why am I pooh-poohing such a generous offer from a carrier? Exactly what motivates me to “look a gift horse in the mouth?” Because I don’t think that this is coming from the gift horse’s mouth at all…rather, I think it’s coming from the other end.

What motive could a carrier have to publicly announce presumably proprietary figures (i.e. information regarding the amount of claims projected to be paid to a specific provider, or set of providers)? Politics, plain and simple.

As noted in the article (and by this blog a while back), Anthem and Premier have hired Lisa Kloppenberg, dean of the University of Dayton Law School, to mediate their discussions. And by announcing these alleged rate reductions in advance, it certainly helps Anthem in the court of public opinion.

I’ll be advising my clients not to spend those savings, just yet.
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