N.H. Firms Hit Anthem Rejection of Co-Payment Plan

March 29, 2004

Anthem Blue Cross and Blue Shield (Anthem BCBS) executives have informed a New Hampshire employer coalition that they will not respond to employer and employee requests to control costs and improve quality through the development of new network products.

Last October, the New Hampshire Healthcare Purchaser Partnership (NHHPP) issued a written request to New Hampshire health insurers for the development of a new insurance product that would differentiate provider co-payments based on assessments of provider efficiency and quality and help consumers become more aware of the value of services they receive. The product specifications were developed through a collaborative, yearlong workgroup process involving employers, insurers, labor, physicians, hospitals, and brokers and cited in the NHHPP’s Request for Proposal.

More than 50 New Hampshire employers, representing some 130,000 New Hampshire employees and dependents, endorsed the RFP and committed to offer the product if Anthem BCBS or another New Hampshire-based health insurer developed it. NHHPP participants include national employers such as Osram Sylvania, Hannaford Bros. Co. and General Electric; large regional employers including the University System of New Hampshire and the Local Government Center, which provides benefits to New Hampshire cities, towns and school districts through it HealthTrust; and employee organizations like NEA-New Hampshire.

“We are very disappointed that Anthem is choosing to ignore the clearly stated interests of its customers,” said Peter Hayes, director of health strategy for Hannaford Bros. Co. and a member of the NHHPP’s Board of Directors.

Donna Marcin, human resource manager for N.H. Ball Bearings Inc. and vice president of the NHHPP’s board of directors, voiced similar feelings.

“This effort is intended to empower consumers in a new and exciting way,” Marcin said of the NHHPP’s recent RFP. “We remain disappointed with Anthem’s decision but are determined to continue representing purchaser and consumer interests while seeking the health care benefit changes outlined in our RFP.”

Anthem BCBS cited several reasons for its response to the NHHPP’s request, including primary concerns that doctors and hospitals would resist the product and that there was no guarantee of significant product enrollment up front.

NHHPP participants point out that other insurers, including Blue Cross of California and Regence Blue Cross Blue Shield of Oregon, have pioneered similar products. They note that the California plan reports premium savings of 15 percent for its new network product.

As a result of Anthem BCBS’ response to the RFP, the NHHPP will ask other insurers to create the differentiated network product.

“Anthem’s position is symptomatic of the struggle to bring change to the current health care marketplace,” said LGC Executive Director John Andrews. Andrews noted that the current health care system “cries out for innovations in delivery of high quality, cost effective care and rewarding those who deliver it” but added that “people are reluctant to be first in the field.” He concluded, “Unless the purchaser community continues to seek innovation and change, the cost of health insurance will only continue to spiral upward and employers and employees will be left with unaffordable premiums.”

Andrews observed that available statistics for selected medical procedures in Maine show that quality care is cost effective care, which merits greater reimbursement. “Doing it right the first time is good for providers, insurers and patients alike as well as everyone’s pocketbook,” he said.

The New Hampshire Healthcare Purchaser Partnership is a statewide coalition of employer and labor organizations seeking to encourage a new benefit system that includes market incentives to reward efficiency and quality and provide improved consumer information. Visit the NHHPP Web site at www.nhhealthcarepartners.org.

Was this article valuable?

Here are more articles you may enjoy.