United HealthCare
United Healthcare is a major insurance provider in this area who consistently underbids other companies to capture more and more business contracts.
They are also consistently one of the two worst payors in the area for services next to Medicaid and Medicare. Many of their fees paid to providers are at or below Medicare levels.
This is done while their corporate profits and CEO salaries are skyrocketing as shown in the following pictures.
We find these salaries to be excessive. If the playing field was level and physicians could work collaboratively to negotiate like other businesses, it would be different. But when we are restrained from fair negotiations, this places the insurance companies at an unfair advantage.
The physicians in our practice have made the difficult decision to proceed with terminating certain contracts with Insurance companies if we cannot renegotiate the terms. Our hands are tied and we have little options other than terminating contracts.
Cost of living increases and our fixed costs go up yearly as we continue to give raises and benefits but have no way of making the Insurance companies increase their reimbursements.
The healthcare climate is worsening for patients and physicians for a number of reasons and I fear it will get even worse before things change. We are probably the first to terminate a major insurance contract, but we will not be the last in Floyd County. Patient access will continue to worsen.
We have elected to inform our patients about our decisions and solicit their help to overcome the problem. Below is a copy of a letter to our patients explaining the situation.
posted by Anonymous at 6:11 AM
6 Comments:
Seriously, I wish you luck in this endeavor. As I am sure you know the real problem is that, so far, United and other insurance companies have always been able to find sufficient numbers of doctors who will work for what they offer. For whatever reasons (i.e., doctors’ fear of being left with no patients; the opportunity to build a larger practice; pressure from long time patients to accept the only insurance available to them) these outfits have been able to shrug off resistance from small groups like your own. It is an example of the “Wal-Martization” of our economy: If someone will do it cheaper, they will get the business.
I believe that the trend is shifting and new younger doctors are willing to make a stand. More established physicians also have reached their limits.
We are attempting to get our Medical Society in the County more active and involved as well.
Again, whether it be physicians standing up and putting an end to insurance companies directing the care of patients or hospitals standing up and saying "we value more nurses at the bedside", we are ready to accept the financial implications of our decisions if it means better overall care for our patients down the road.
We will work with any patient, any time regardless of what insurance they have or do not have. But we expect them to work with us as well and begin standing up against the establishments that are draining our healthcare system.
HB: When reading your last entry, I thought I could hear the strains of "Solidarity Forever" being quietly hummed in the background.
At some point the tension between care givers and insurance company/government payers will probably get closer to a point of equilibrium…but there will always be some tension there and that is probably a healthy, if stressful, process. Insurance companies are frequently pictured as bullies and bad guys, but they really did force a lot of unnecessary expense and inefficiency out of health care. Until they stopped paying for it, who knew that a healthy woman didn’t need to spend four to six days in the hospital following childbirth? Twenty-five to thirty years ago, a non-life threatening hospital stay was widely viewed as a quasi-vacation—a chance to lay around for a few days, be waited on hand and foot and, if you were lucky, you might even get a sponge bath from a pretty nurse.
I do understand the pain that doctors (and all other care providers) are going through but it isn’t much different than the pressure on, say, General Motors suppliers to operate more efficiently and with smaller margins if they want to do business with GM. Same with Wal-Mart suppliers. It can be brutal for individuals, but usually benefits the overall economy by encouraging innovation and best practices. At least the work that doctors do can’t be outsourced to India or China.
I do differ with you on whether this will be settled by doctors or hospitals taking a stand on principle. Principle doesn’t pay the bills and no business can last long by taking principled stands rather than paying close attention to the income/expense statement. The marketplace will eventually sort this all out, but there will surely be casualties along the way. The day of the standalone hospital or small medical practice may go the way of the Mom and Pop grocery.
"Twenty-five to thirty years ago, a non-life threatening hospital stay was widely viewed as a quasi-vacation—a chance to lay around for a few days, be waited on hand and foot and, if you were lucky, you might even get a sponge bath from a pretty nurse."
Huh?
Is this supported by fact? Just curious.
Is this supported by fact? Just curious.
I would say that statement is well within the evidentiary standards previously established on this blog.
Not a particular point to this, but did you notice the highest paid person at United is a doctor?
Highest paid by far. I assume he founded United since he is Chairman and made so much.
HB, met your neighbor and friend RS for the first time last night. You are correct about him being a good guy.
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