WellPoint At Bottom of Hospitals\' Payer List
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. For the same reasons: Denied claims. Low reimbursement. Late reimbursement. Thickets of red tape.
Each year ReviveHealth, a hospital public relations firm in Santa Barbara, Calif., asks hospitals to name the most problematic payers. This year’s loser: Indianapolis-based insurance giant WellPoint, Inc. 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 first 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 spokesperson Jill Becher. “We have a long history of working with providers to improve the accessibility, affordability and effectiveness of quality healthcare.”
Rising from the basement in previous surveys was Minneapolis-area insuer 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.
Allan M. Korn, M.D., 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 spokesperson. ”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 healthcare.”
The Independent Blues account for about 21% of the net revenue received by the health plans surveyed, according to Revive. WellPoint accounts for about 15% of the revenues, while UnitedHealth accounts for about 10%.
The payment environment as perceived by hospitals is not expected to improve anytime soon. According to Revive’s survey, 76% of hospitals believe the ongoing implementation of the Affordable Care Act will reduce their reimbursements.
Provided by Kaiser Health News (www.kaiserhealthnews.org). Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
