By Rosana Garcia
“We have these two big juggernauts going at it, and the bottom line, from our point of view, is, ‘How does the consumer benefit from any of this? And who is looking out for the consumer in all of this?’ ” said Lynne Ide, director of advocacy at the Universal Health Care Foundation of Connecticut. “They have no way to insert their voice into the process.”
From the Norwich Bulletin, 10/1/2014
We have woken up to an October where Hartford HealthCare and Anthem are no longer friends. On October 1, 2014, it was announced that Hartford HealthCare (HHC) hospitals and some facilities are no longer part of the Anthem Blue Cross & Blue Shield network, due to a breakdown in contract negotiations.
This means that Hartford HealthCare’s hospitals are no longer in-network for those insured by Anthem, including:
- Hartford Hospital
- Backus Hospital in Norwich
- Mid-State Medical Center in Meriden
- The Hospital of Central Connecticut in New Britain
- Windham Hospital
If no deal is reached by November 1, 2014, even more facilities will fall out of network.
Governor Dannel Malloy and Lt. Governor Nancy Wyman released a joint statement stating that “Both companies need to return to the table and work out a deal that protects the health of Connecticut residents.”
In a statement from Attorney General Jepsen and Healthcare Advocate Veltri expressed disappointment in the lack of resolution on this issue. In the Norwich Bulletin, Veltri also said: “There’s not a lot of information on which consumers can evaluate what’s happening with this whole situation. Consumers being in the dark about it is not very helpful.”
It is promising that Connecticut’s officials are on the side of the consumer in this situation. But it is frustrating that consumers have no voice in this process when they are, arguably, the ones with the most at stake. As long as the fight between Anthem and Hartford HealthCare continues, consumers and patients are left to deal with an unfair level of uncertainty. Anthem members in the midst of receiving care from a Hartford HealthCare facility have been told to call Anthem to find out whether they may be liable for unaffordable out-of-network costs. Instead of focusing on their own health, they have to worry about getting bills they may not be able to pay.
Where are the consumer protection measures to simplify this tangled situation? If both Hartford HealthCare and Anthem have failed to come to a resolution, why is the onus on the consumer to figure out what this means for their health and their wallet?
The sheer size of the Hartford HealthCare network and Anthem’s large market share in Connecticut really matter. More and more hospitals and physician practices in Connecticut have become concentrated in just a few statewide networks. Meanwhile, despite some new entrants in the health insurance market, Anthem’s market share remains by far the highest in Connecticut. When two “juggernauts” collide, more people bear the brunt of the consequences.
Consumers have little-to-no information about the negotiations happening behind closed doors. What little is known points to the fact that there are disagreements about what Hartford HealthCare will be paid, as well as Anthem’s efforts to tie those payments to quality. These are important issues to resolve, as consumers generally have little confidence that their health care dollars are being spent wisely.
We hope that this contract dispute will be resolved very soon. But, in the meantime consumers deserve to be protected and have their voices heard.
Are you insured via Anthem and wondering about your care? The Courant has 8 Things You Need to Know About Anthem, Hartford HealthCare Split.
Hartford HealthCare has more information for patients here.
Anthem has more information for consumers here.
Interested in reading more articles about this issue? Here are some:
- Courant: Malloy, Others Admonish Hartford HealthCare, Anthem for Failed Negotiations (10/1/2014)
- CT Mirror: With no deal, Hartford HealthCare’s five hospitals leave Anthem’s network (10/1/2014)
- Norwich Bulletin: Backus, Windham hospitals dropped from Anthem network over contract dispute (10/1/2014)