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More hospitals seek contract parity among insurers
In some states such as Massachusetts, hospitals are being pushed to accept minimal payment increases or even outright cuts by health insurers bent on negotiating more advantageous contracts. However, in other states hospitals are the ones doing the pushing. Increasingly, some hospitals are asking health insurers to re-negotiate contracts for parity (i.e., they want all insurers to pay the same) - a move that has them asking for payment increases as high as 60 percent in some cases.
Earlier this month, Hanover (Pa.) Hospital ended negotiations with Capital Blue Cross after the Harrisburg, Pa.-based health insurer failed to fully come up to the same base reimbursement level provided by Highmark, Aetna and HealthAmerica Pennsylvania. (The insurer offered a combination of base payment and pay-for-performance increases to achieve parity.)
Now UnitedHealth Group subsidiary UnitedHealthcare in Orange County, Fla., has sent letters warning members that its contract with Florida Hospital sites likely will end on Aug. 15. UnitedHealth pointed out that Orlando-based Florida Hospital wants payment increases of more than 60 percent, reports WESH-TV.
Florida Hospital expressed its parity goals clearly in a recent press release, stating "Florida Hospital is committed to having all large health plans pay the same rates for healthcare services" and "Florida Hospital seeks to blend multiple rate schedules so that all insurance health plans pay the hospital at the same rate."
Upstate University Hospital in Syracuse, N.Y., appears to be in a similar standoff with Aetna, reports The Post-Standard. Aetna currently pays the hospital roughly what it pays other area hospitals, according to spokeswoman Susan Millerick. However, there's a good chance that Aetna's payments aren't on par with other insurers. While Upstate University Hospital hasn't specifically cited parity, the hospital has requested a 50 percent pay increase in the first year of a three-year contract.
To learn more:
- read this Florida Hospital press release
- read this WESH-TV report
- read this report from The Post-Standard
Related Articles:
Massachusetts insurers leading charge to control provider payments
Pennsylvania's third-largest insurer in ad war after contract talks fail over 'parity'
Hospitals to see more contract pressures from commercial insurers
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Comments
Ask and you will get it. the new basis for parity for hospital and physician payment will be the Medicaid rates. See what is happening in MA, NJ, NY..
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