Beginning next year, Bristol Hospital could be out of Anthem Blue Cross and Blue Shield’s network, meaning that Anthem members who use the hospital would be charged out-of-network rates for all but emergency care.Bristol hospital gave notice that it will terminate its contract with the insurer after the two sides were unable to agree on reimbursement rates. Unless they reach an agreement, the contract will end Jan. 1.The two sides are scheduled to talk next week but representatives of both the hospital and the insurer said they remain far apart.Bernadette Kelleher, Anthem’s vice president of provider engagement and contracting, said that the company has proposed an increase in rates for the hospital but that the increases the hospital is seeking are “a non-starter.”"It’s not something we could accept,” she said. “The challenge there is that the level of increase right now, with the current economic environment, individual employers, individual customers, they really just can’t continue to absorb very high, double-digit rate increases.”Peter Freytag, Bristol Hospital’s chief financial officer, acknowledged that the hospital is seeking a large rate increase, but said that is because Anthem’s previous contract paid lower rates than other private insurance companies.”They have been underpaying us for years,” he said.Anthem said the hospital is seeking an increase of more than 20 percent. Freytag said the hospital offered 9 percent as part of continuing negotiations.Freytag disputed the idea that an increase in payments from Anthem would require higher insurance rates for Anthem’s customers. He said the increase Anthem offered would make it difficult for the hospital to cover its costs and replace equipment necessary for quality care.Anthem’s proposed increase would still pay the hospital lower rates than the other private carriers, he said.Similar standoffs have happened in Connecticut this year, in one case involving Anthem. Hospitals typically offset some of the money they lose on Medicare and Medicaid coverage through the rates they charge private insurers.Anthem, which has about 1.4 million customers in Connecticut, accounts for 19 percent of the hospital’s business.Last March, Bristol Hospital briefly stopped accepting United Healthcare insurance after negotiations failed to produce an agreement. The two sides reached a new contract the following month.Around the same time, talks between Anthem and Middlesex Hospital over their contract broke down, leading Anthem to send letters telling its members the hospital would no longer be part of its network. The hospital and insurer reached an agreement before that happened.
Posts Tagged ‘rates’
Bristol Hospital, Anthem In Standoff Over Reimbursement Rates
Friday, February 26th, 2010Doctor launches firm to help patients cut big hospital bills: the plan: reduced rates for promised prompt payment. (David Thomas of Patients Hospital Discount … An article from: San Diego Business Journal
Friday, February 26th, 2010Product Description
This digital document is an article from San Diego Business Journal, published by CBJ, L.P. on March 4, 1991. The length of the article is 887 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.
Citation Details
Title: Doctor launches firm to help patients cut big hospital bills: the plan: reduced rates for promised prompt payment. (David Thomas of Patients Hospital Discount Contracting Service)
Author: Bradley J. Fikes
Publication: San Diego Business Journal (Magazine/Journal)
Date: March 4, 1991
Publisher: CBJ, L.P.
Volume: v12 Issue: n9 Page: p8(1)
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Feeling the pinch: low Medicaid reimbursement rates squeeze local hospitals.: An article from: Fairfield County Business Journal
Wednesday, February 17th, 2010Product Description
This digital document is an article from Fairfield County Business Journal, published by Westfair Communications, Inc. on March 15, 2004. The length of the article is 744 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.
Citation Details
Title: Feeling the pinch: low Medicaid reimbursement rates squeeze local hospitals.(Focus: health care and employee extras)
Author: David Gurliacci
Publication: Fairfield County Business Journal (Magazine/Journal)
Date: March 15, 2004
Publisher: Westfair Communications, Inc.
Volume: 43 Issue: 11 Page: 13(1)
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The uninsured: Montana’s health insurance coverage rates are among the worst in the nation.: An article from: Montana Business Quarterly
Thursday, February 14th, 2008Product Description
This digital document is an article from Montana Business Quarterly, published by University of Montana on December 22, 2003. The length of the article is 3784 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.
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Title: The uninsured: Montana’s health insurance coverage rates are among the worst in the nation.(Health Care)(Cover Story)
Author: Steve Seninger
Publication: Montana Business Quarterly (Refereed)
Date: December 22, 2003
Publisher: University of Montana
Volume: 41 Issue: 4 Page: 2(6)
Article Type: Cover Story
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Federal Register, V. 69, No. 154, Book 1, Wednesday, August 11, 2004: Contains Hospital Inpatient Prospective Payment Systems, Fiscal Year 2005 Rates
Wednesday, October 31st, 2007Product Description
Contains: Part 2, Department of Health and Human Services, Centers for Medicare & Medicaid Services, 42 CFR Parts 403, 412, et al., Medicare Program: Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2005 Rates; Final Rule. Also contains other proposed rules, new rules, and notices.
Prospective payments to hospitals: should emergency admissions have higher rates?: An article from: Health Care Financing Review
Thursday, June 21st, 2007Product Description
This digital document is an article from Health Care Financing Review, published by Superintendent Of Documents on March 22, 1989. The length of the article is 6230 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.
Citation Details
Title: Prospective payments to hospitals: should emergency admissions have higher rates?
Author: Glenn A. Melnick
Publication: Health Care Financing Review (Refereed)
Date: March 22, 1989
Publisher: Superintendent Of Documents
Volume: v10 Issue: n3 Page: p29(11)
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