Shots - Health Blog
Tue August 21, 2012
Hospitals Gripe About Health Insurers, Too
Originally published on Tue August 21, 2012 10:19 am
It is a truth universally acknowledged that health insurance companies can be a pain for patients. What may be a surprise is that hospitals often complain, too. And the reasons aren't so different from those of consumers: Denied claims. Low reimbursement. Late reimbursement. Thickets of red tape.
Each year ReviveHealth, a hospital PR firm in Santa Barbara, Calif., asks hospitals to name the most problematic payers. This year's loser: WellPoint, which "managed to have some pretty intense negative opinion" in the regions where it does business, said Revive President Brandon Edwards. "That vaults them above — or I should say below — all the other health plans, even those that operate in all 50" states.
Insurers called the report unscientific and biased, pointing to the agency's interest in cultivating hospital clients. (Here is Revive's press release.) Edwards says the research was commissioned by Revive but performed by a third party — Monigle Associates — which contacted every hospital system in the country and received responses from more than 400.
WellPoint ranked last in overall favorability and in the "dealing with hospitals" category. Cigna was No. 1 in overall favorability while Aetna scored best in the dealing with hospitals category.
"We believe the Revive survey is inherently flawed and without merit," said WellPoint spokeswoman Jill Becher. "We have a long history of working with providers to improve the accessibility, affordability and effectiveness of quality health care."
But some insurers liked the report just fine. Here's Cigna spokesman Joe Mondy, via email:
"Sorry to see some attacking the survey — Cigna did quite well, so maybe it's easy to say – but we view data from this and other 'report cards' (athenahealth, AMA) as very useful in identifying opportunities to improve and gaug[e] the impact of past improvement initiatives."
Rising from the basement in previous surveys was UnitedHealthcare, the country's biggest private health insurer. United scored sixth out of seven in the dealing with hospitals category and fifth out of seven in overall favorability.
"United certainly hasn't moved to a point where people say, 'It's a great health plan for me to deal with,' but it's only fair to acknowledge that they've made some pretty big strides in improving their reputation in the provider community," Edwards said.
Independent Blue Cross and Blue Shield plans ranked worst in hospital payment rates for the second year in a row.
Dr. Allan M. Korn, chief medical officer for the Blue Cross and Blue Shield Association, defended the Blues' relations with hospitals and doctors.
"Revive is a PR firm that represents medical providers in payment negotiations with insurers and often creates a contentious public and media atmosphere around these talks," he said through a spokeswoman. "This survey is merely another tactic aimed [at] boosting payments for Revive's clients without regard to the impact this has on millions of Americans who want and deserve affordable health care."