Thousands of consumers are caught in the middle of a contract dispute between Anthem Blue Cross and Blue Shield and Hartford HealthCare. Anthem and Hartford HealthCare are at a stalemate over setting the price that the insurer will pay when its customers use the network’s hospitals.
The new contract year begins on October 1. Hartford HealthCare’s network currently consists of five hospitals: Hartford, Mid State Medical Center, The Hospital of Central Connecticut, Windham and Backus.
A recent CT Mirror article points out what’s at stake for Anthem members who use Hartford HealthCare providers: their wallets and their care. The ongoing consolidation of hospitals into large networks like Hartford HealthCare or Yale New Haven Health System is leaving consumers fewer choices. For example, if an agreement can’t be reached, an Anthem member living in eastern Connecticut would find two key hospitals: Windham Hospital and Backus Hospital to be out of network. Their option would be to travel much further to use a different, unfamiliar facility or incur higher costs for using an out of network hospital.
Hospital consolidation is a trend that is speeding up in Connecticut and is likely to continue. A report this week says that small, stand-alone hospitals are reaching a financial “tipping point,” in the wake of declining patient volume and other pressures. This consolidation is also giving large hospital systems more negotiating power, which could mean higher insurance premiums for consumers. As Healthcare Advocate Victoria Veltri said in the article, “The thing we’ve always been worried about is that [with] greater consolidation, the large systems could use that bargaining power…to extract more…”
What is worse, negotiations like this one go on behind closed doors. Whatever deal is struck, consumers will ultimately be paying the bill. And, given the lack of transparency around hospitals’ costs and prices, quality of care or insurers’ profit margins, consumers will have little to no information about what they will be buying with their hard-earned health care dollars.
Consumers are pawns in this game. No matter what happens, they are sure to lose.
Anthem members who have concerns or questions about getting access to care at a Hartford HealthCare hospital if the contract is not settled prior to October 1 can contact the Office of the Healthcare Advocate by phone: 1-800-466-4446 or by email: email@example.com
If you would like to become involved in speaking up on behalf of consumers on this and other health care issues, contact Universal Health Care Foundation of Connecticut by email at: info@UniversalHealthCT.org