Cigna's threat
Many people have asked me to comment on the article in the Courier on Wednesday regarding Cigna possibly dropping Floyd County Hospital from its network.
Cigna may boot hospital from network
The bottom line is that the hospital has made the right choice up to this point. They have been in negotiations for months and basically had a deal worked out. Cigna then came in and reneged on the agreement. The article in the paper is one-sided and does not present the entire picture of what has transpired over the past several months.
The Hospital, as well as the physicians, needs to stand their ground and allow Cigna to walk away. Patients need to know both sides of this story and patients need to press their employers to put pressure on Cigna.
Cigna’s primary concern, as a third party payer, is not about the welfare of the patients. Cigna, like every other insurance company, has its first priority to its stockholders. Their primary goal is to make a profit. The way they continually maintain the increasing margins is by cutting payments to physicians and hospitals or by eliminating services provided to patients.
The publicity of this article sent tremors through some in administration and it certainly put Floyd on the defensive, but Floyd has done the right thing.
I hope that our CEO and others in his administration does not buckle to the pressure because of the publicity. It would show their continued poor judgment in critical decisions.
Cigna may boot hospital from network
The bottom line is that the hospital has made the right choice up to this point. They have been in negotiations for months and basically had a deal worked out. Cigna then came in and reneged on the agreement. The article in the paper is one-sided and does not present the entire picture of what has transpired over the past several months.
The Hospital, as well as the physicians, needs to stand their ground and allow Cigna to walk away. Patients need to know both sides of this story and patients need to press their employers to put pressure on Cigna.
Cigna’s primary concern, as a third party payer, is not about the welfare of the patients. Cigna, like every other insurance company, has its first priority to its stockholders. Their primary goal is to make a profit. The way they continually maintain the increasing margins is by cutting payments to physicians and hospitals or by eliminating services provided to patients.
The publicity of this article sent tremors through some in administration and it certainly put Floyd on the defensive, but Floyd has done the right thing.
I hope that our CEO and others in his administration does not buckle to the pressure because of the publicity. It would show their continued poor judgment in critical decisions.
posted by Anonymous at 6:11 PM
27 Comments:
I think the devil just sent out for hot chocolate!!
Cigna's threat? What about United Health Care? You speak of profit. I WAS a patient of Physician Associates for many years but I got a letter from PA telling me PA was dropping out of UHC network because UHC wasn't paying enough money. When in fact UHC takes charges Drs charge in this area and pays the AVERAGE. Just maybe doctors are trying to bully the insurance companys to make THIER pockets fatter. Maybe the insurance companys are trying to keep cost down so it doesn't raise insurance premiuns to us the patients. You knock insurance companys for making a profit are you in your profession for a hobby? I think its for profit also. I know I was in my profession was for profit. Maybe Drs. should stand back and look at what is going on before its to late. Because I like many others will go on and find a good doctor who will accept my insurance. SIN ME A FORMER PATIENT OF PHYSICIANS ASSOCIATES!!!!!!!!!
"I have no intention of obtaining privileges elsewhere to satisfy Cigna". Ugh runawaydoc, I don't think Cigna cares, it's your patients you would be satisfying.
Not to argue with anonymous, but you are really poorly informed.
United Healthcare is paying rates lower than medicare reimbursement. Offices cannot survive on those reimbursements and continue to cover overhead and employee salaries. I have posted extensively on this if you care to go back and read them.
The majority of our United Healthcare patients have elected to stay with our office and we will work with each patient individually to meet their financial needs. Try to do that with one of these insurance companies.
Why should physicians have to practice out of more than one hospital. It is not worth our time. Or is our time of no value?
Patients need to also think of these things. Healthcare is not a right!!
I can understand why Dr's drop certain third party payers. I have heard from different Physicians that they have to work harder every year just to earn the same income from the previous year. Some can't even take a 4% pay increase that they are giving their employees.
We need to make some changes in Healthcare or no one is going to want to be a Family Doctor. I personally believe most Dr's work hard and deserve to make a good income. Just because a Dr has to make changes in their office due to business reasons doesn't mean they don't care and they are only in it for the money. My belief is if you want to make a Dr's income go to medical school and work 60 to 80 hrs a week and you can make their income. We need to take care of our Doctor's or it is going to become a minimum wage job and our healthcare is going to go way down.(I know that is a little bit of an exaggeration, but you get the point.)
I work at a Veterinarian's office and one of the Vet's I work with has elderly parents who need a lot of medical care. We have discussed their medical bills and how the Dr or Hospital, due to the third party payers, receives less pay for some medical procedures than the Veterinarian. I do understand that the Dr's and Hospitals negotiate their pay from the insurance companies in advance. My point is they have every right to pull out when they do not feel like they are compensated well for their work.
HB, You have just showed what you think of your patients when you said quote "Healthcare is not a right!!" I hope every patient that you still have will read that statement. True, healthcare is not a right but when you put your name on the door with MD behind it I would think that the first and foremost thought would be that you were their for the people that would walk thru it. I would hope that you would rethink that statement. I was your patient once and I can testify as to your
treatment of me and I can tell you this you were all wrong in your diagnosis, by your simplistic attitude. Granted I had to see 2 other doctors before being correctly diagnosed. Not all Doctors are always right. Granted most Doctors are feeling the crunch because they had help that they were underpaying and now that they have been made to pay for good help that is causing them to look at their own bank account. In years past Doctors had pretty much free rein. You are dropping insurance companys but have you ever thought the buck has to stop somewhere. I have had a high ranking employee at a hospital tell me (after they failed to send a muscle biopsy out and it was too degraded to use,) not to worry about it Medicare pays anything. I am sure that if Medicare was competent in what they were doing, that the next step for all you Doctors and hospitals would be to drop them too. You can be judgemental about what you provide but the statement that heealthcare is not a right is the worst thing I have ever heard. I wonder if that is something you just decided or is that was what you thought when you went into the profession. Maybe you should move on to something else if thats the way you feel. The Floyd County and NA police needs officers. Get out there and put your life on the line everyday. Then you will be in the real world. Get over it. You are not entitled to be regarded as special just because you have Dr.
before your name. Also, maybe you
should have been a Veterinarian then you would not have to worry about the cost of mal-practice insurance and you would not have to bother with insurance companies.
at all. I guess that would not fly, because you could say the same about animals, "HEALTH CARE IS NOT A RIGHT". I think you should discuss this attitude with your Priest.
Again, it is sad that you are this bitter and this misinformed on so many issues.
I stand firmly on the statement that healthcare is not a right.
That in no way means I don't believe every individual should have some means to access the care they need. But they need to be responsible for the care. They need to pay for the care or arrange for payment in some method.
Doctors are human and we do make mistakes. Medical care is not an exact science and there is no "tricorder" you can run over a patient to get a diagnosis. Much of what we thought was true 10 years ago has been proven incorrect and what we think we know now will be proven different down the road. It takes both physicians and patients working together to finally get difficult diagnoses.
Doctors also have families and personal lives and should be allowed to maintain an appropriate balance between professional and personal lives.
If you read any current literature, vets are now being sued more and more and are beginning to worry about malpractice issues as well.
ATTENTION ALL HUMAN DOCTORS!!!! BE ANIMAL DOCTORS AS EARLY AS TODAY!!!!!!!!!!!!!!!! WE WANT YOU, YES, YOU!!!!!!!!!!!!! ARE YOU TIRED OF YOUR BORING, LOW PAYING JOB CAUSED BY SICK HUMANS? WELL, WE HAVE AN ANSWER TO YOU PROBLEM!
VETS ARE IN SHORT SUPPLY IN THE UNITED STATES. THE EDUCATION (VETS MIGHT HAVE MORE) IS COMPARABLE, AS SO ARE DOCTOR FEES AND MEDICATIONS. THE HOURS ARE BETTER. NO MALPRACTICE INSURANCE IS REQUIRED. YOUR TECHS WILL DO MOST OF THE PHYSICAL LABOR (DIRTY WORK). YOU JUST STAND BACK AND OBSERVE (GREAT, HUH)! YOU'LL GET EVERY PENNY YOU ASK FOR. NO PARTIAL INSURANCE/MEDICARE PAYMENTS.
IF YOU CAN'T CURE 'EM OR THEY CAN'T PAY, YOU CAN SEND THEM HOME TO DIE OR BETTER YET PUT 'EM TO SLEEP!!!!!!!!!!!! I BET YOU LOVE THE "PUT 'EM TO SLEEP" PART, DON'T YOU? I KNOW THIS HAS BEEN A WORRY. WELL WORRY, NO MORE!!!!!!!!!!!!
NOW!!!!!!!!!!!! HOW CAN YOU RESIST THIS OFFER. SIGN UP TODAY AND BE FREE FROM THE HUMAN RACE AND ALL THEIR COMPLICATIONS! TREAT A CAT OR DOG..................T-O-D-A-Y!!!!!!!
NOTE: HAVE SOMEONE HUM "MY COUNTRY TIS OF THEE" AS THIS IS READ ALOUD!
Well I was trying to not respond to anonymous 12:28, but I have to ask WHAT IS YOUR POINT???
I have to agree with Dr. Eichenberger vets do have to worry about malpractice issues. We are living in a society were there is no personal responsibilty it is always the other persons fault.
TECHS WILL DO MOST OF THE PHYSICAL LABOR (DIRTY WORK). YOU JUST STAND BACK AND OBSERVE (GREAT, HUH)! Not in the practice I work at!!!!
IF YOU CAN'T CURE 'EM OR THEY CAN'T PAY, YOU CAN SEND THEM HOME TO DIE OR BETTER YET PUT 'EM TO SLEEP!!!!!!!!!!!! AGAIN Not at the practice I work at!!!!!! We love our patients and we are very very upset when they are humanly euthanized or die at home, we HATE that part of our job. I have to say that if you own a pet they come with responsibilities. One of those being financial if you can't afford to take care of them you shouldn't have them.
As far as getting every penny you ask for, think again. Vets also deserve to be paid for their services.
For anonymous 11:29 I disagree with you. You said "HB, You have just showed what you think of your patients when you said quote "Healthcare is not a right!!" I am a patient of Dr. Eichenberger's along with my husband and son and we have trust in him and his staff. I do not think he doesn't care because he doesn't feel finacially responsible for our healthcare. That is our responsibility. Veterinarians are not finacially responsible for pets(WITH OWNERS) healthcare either.
I wrote about UHC this morning and being a FORMER patient. How is PA working with patients? Are you going to give discounts because we are out of network? I think not.I called the insurance company and they said since PA was going to be out of network I would have to pay the first $400.00 and 20% of the bill the rest of the year where as I pay a $15.00 co-pay each visit in the network. Now if I have to pay this first $400.00 and 20% after that is UHC still paying the AVERAGE and you working with patients are pocketing the $400.00 PLUS 20% eack visit? I still have the letter you wrote your patients informing them of your decision to dowp UHC and reasons. But I also recieved a letter from UHC with their side of the story of course the insuance side is all wrong so I guess I must be am misimformed. You know the old saying "I can reach in your pocket but don't reach in mine" It sounds like you have been working with salesman not patients.
Runaway doc, If you are referring to me I worked in a office doing an accountants work, at a clerk's pay for 30 plus years. I handled all the duties of an accountant, and was advised of this in my last month of work. I did all the accounting by hand, without the use of computers working each month till midnight just to close out the books and produce reports for management. I did not complain about this as I was working for a large National Co. and I was just glad to have such a
wonderful job. I started at $2.40 hour, 30 years later I made $14.40 an hour. I know what I pay for when I go into a Doctors office and the amount of time spent with me as a patient. I have nothing personal against Doctors or Hospitals either, but after listening to a police scanner, I am amazed at the many many runs the police and yellow ambulance makes to FMH with people that have stomachaches headaches, backaches,
and every other ache that you can think of. By the addresses that come over the scanner you know that these people are using the emergency room as their family doctor. Someone is seeing and treating these people. You Doctors are not trying to stop this practice, you instead are taking out your frustrations on people that have worked all their life and tried to play by the rules. By the way try working 30 years and receiving a measley $286.00 pension. Also try getting your fees from the people you are seeing that has no insurance coverage whatsoever. Hell yes I am bitter, I once tried to get a relative into a nursing home because she had to leave the hospital and was told sorry we could get her in today if she was on MEDICADE, but otherwise it will take several weeks. Even at that she would be put back thru the dining room to a small room, while all the empty rooms up front was reserved for MEDICADE people. Instead of taking your fight to the Insurance Companies, take on the Government. What all must remember, if your lucky and your HealthCare Provider makes the right decisions that pertain to your healthcare, hopefully it will lead to a long and productive life. So if there is a problem now it will just compound in the future. As I said the Buck has to stop somewhere. There is no one in any profession being given a free ride. Why do you think so many people change professions. They are unhappy,or have disillusioment
with what they are doing. I feel that many people today have gotten into their professions for the wrong reasons, not because they love what they are doing but because of the financal gain they expect to receive. If thats the case, maybe it would be better to move on. By the way, yes I am financially able to pay my bills, but for Doctors it is with my insurance companys help. Because none of the professionals that I have had to hire charge anywhere from $75.00-$80.00 for 4 or 5 minutes of their time. Think about it!
PA's decision to discontue with United Healthcare has nothing to do with my comment at 10:02. runawaydoc has obviously accepted Cigna's reimbursements up to now, it is FMH that is choosing not to continue. runawaydoc's patients are with Cigna now either because it is the only plan their employer offers or it is the best one they have to choose from. By refusing to give his patients access to another hospital, he is only hurting his patients. All this is likely moot as these disputes are usually settled at the last minute.
So many comments could be made regarding the last couple of postings, but I think we all agree that the overall system is broken.
Doctors and patients need to take back control of healthcare. We are taking a stand with 3rd party payers and are actively meeting with our legislators.
We will continue to work with every one of our patients individually to meet their needs.
We can only do that when our patients inform us of hardships, special situations etc.
Very interesting comments made today.I just can't wait for tomorrow...:)
I am sorry if I offended the vets and vet techs in the animal world. I merely meant if your animal can't be cured you have only two alternatives. I have spent thousands on my pets and have received excellent service for that money. I would spend thousands and more all over again (and probably will). Enough said.
I was trying to drive my point home to the "human" doctors. It would be much easier, especially since they are not being compensated monetarily (as they say) for their time and trouble to put us to "sleep". The "new-age" doctor thinks you have lived a full life at 50 and anything above that age is a plus. Many of us feel doctors would love to "put to sleep" the elderly (over 50).
Now, won't you be looking at your doctor and wondering if he/she is concerned about your well-being or how much money he/she will receive from your insurance company. God, help the "poor" soul without insurance or welfare, but then again, he won't be seen by the doctor, will he.
My advice for the "belly-aching" doctor(s)is: "If you don't like your job or the money, QUIT". It's done every day. What kind of service are giving, if, you don't like what you are doing, for whatever reason.
Humans, or at least this one, have always wonder how sincere doctors are. Now I know, you are driven by GREED. Just remember, Mr./Ms. Doctor, you are NOT GOD, even if we make you feel that way. You are to my body as a mechanic is to my car.
I can remember seeing my Granddad
counting his dimes, which he had saved in a Ball jar when he had to go to the Doctor. He had no insurance coverage, because it was not something that was a given back then. He took responsibility for paying for his healthcare, and believe me he was not able to save many dimes. So needless to say he did not go to the Doctor very often. By the way, when I attended my Grandpa's funeral he was 66 years old. Maybe, just maybe the Baby-Boomers will take us back to the "good ole days". I believe if I had made anywhere from $60-$80. for 4 or 5 min. of my time, I
would not have to worry about paying for healthcare or anything else. I know of many fine Doctors that have come to this country and studied under the Physicians here and they are being shipped back to their own countries because they cannot get privledges to work in our hospitals. Local Doctors and Local Hospitals take care of each other. It does not take a Rocket Scientist to figure that one out.
Comments as the ones seen here, show this complete lack of understanding of how the current healthcare system operates and the significan bias and almost "brainwashing" certain individuals have towards physicians.
Employees in every profession who work hard and do their jobs should be able to expect advancements in salary and/or positions. It's the American way.
The CEO at Floyd and most other hospitals make far more than 95% of the primary care physicians. They also have retirement plans paying them anywhere from 65%-80% of their salaries for 20 years after their retirement.
CEO's of insurance companies make millions and many other professions make far more than primary care physicians with a lot less eduacation or time spent in their fields.
Physicians are no different. We provide a service and should expect to be paid for that service. Overhead expenses average about 55% for most primary care doctors and inflation and other expenses continue to increase just as every other field.
Hospitals and physicians do not take care of each other and cannot because of current laws. That is part of the current problem. Your fundamental lack of understanding, again demonstrates the purely emotional responses we have seen here.
Big insurance companies and lobbyists have continually taken over healthcare at the expense of patients and physicians.
Physicians can "quit" as mentioned, but it will not be that we quit taking care of patients.
It is that we quit taking certain insurance as we are beginning to do. Patients will continue to need the service we provide and those who value the service will find ways to pay for the service.
If Physicians would begin taking only payments from patients we could cut our overhead by at least a third to half and be able to drop the current charges by 50%. The patients could then have their insurance reimburse them at the discounted rates they give us.
Things would change in a hurry if that occured. But that is the way every other type of insurance works except in the Medical profession.
runawaydoc you wrote to anonymous telling how rough you have had it $50,000 student loan did you ever hear of a real job? I work when I went to school and I went out and worked 7 days a week 12 hours a day to put my kids thruugh collage and when the overtime dried up I got a second job mowing grass and cleaning offices without a loan!! My 1 child is still going to collage to get her 3rd master degree afer 10 years of collage. She has a home lives by herself works 2 jobs and goes to UL. Loans? She pays every penny herself.ITS CALLED THE AMERICAN WAY So I really feel sorry you have to pay back your loans. Maybe you should have worked then and not worried about it now!! As for the as the 600% pay increase and $286.00 per month pension I am sure He would trade his salary for your salary I know I would plus your new cars and big homes I'll trade my old Chevy and 1000 square home for yours ANYDAY.On second though maybe not maybe other loans HEHE! So when you are crying about rough life step into the raal world you would be amazed about whats out here.
Whoa HB! People read the message
HB just posted at 8:39. You are crying because your expenses are 55%. If my math serves me right you are pocketing 45%. Evidently you are working 5 days a week because you have also talked about finally getting a short vacation. Now, there are at least 5 working days a week, 8 hrs. a day, 260 days (give or take for holidays) a year. 60 min. an hour. Let the people decide just how many min. you spend with them each hour, and let them check their charge for those min. Then they will be able to see what all the comments are about. It does not take an uninformed, bias person to fiqure this out. In fact, it does not even take an educated person, just someone with common sense. I'm pretty sure this string will come to a close, because I see when you have no answers to the hard pressed questions you move on, to something else. By the way, I love my Doctors, they all have wonderful attitudes and they love what they are doing, and they have no problems with my Insurance Co. and besides that I get to enjoy the scenery when I drive across the river. My Insurance Co & I would like to thank you for that!!
Who among us(me included)feels overpaid for whatever it is that we do? This thread has dissolved into how much money is enough or not enough. Let's face it, no one REALLY knows what someone elses job/profession is really like.
As for as health care not being a "right", I agree. Along the same lines, actual increases in net income are, also, not a "right".
iamhoosier
You are exactly right and on target with very good common sense as usual.
No one has these rights and no one knows what anyone's job is like unless they've done it. It certainly isn't a 5 day/week 40 hour job
Thanks for the compliment.
The check is in the mail!!
Once again you are justifying the comments posted with a simplistic
attitude. No one has said healthcare is a right,I have said it is outrageous for a Doctor to say that when he went into the profession just to deliver healthcare. What if everyone had this attitude. For example, a Policeman if they would be presented with the choice of saying "It is not a right for me to protect someone that is in harm at the expense of my own safety." They do not stop doing what they were hired for just because of what is a right or not a right. The point I am trying to make is that there is nothing in peoples life that is a guaranteed right There comes a point in time that people have to realize that what they choose as a profession either lets them enjoy what they are doing or lets them be unsettled and disgruntled, whether it be from lack of commitment or just burn out with the whole scenario.
Not be upset because they can't raise their 45% profit to 50%.
I agree everyone needs an increase in income at some point. That is why I am grateful for the 4% I received in my Social Security Payments this year. But as a Business person you could increase your income by either seeing 1 or 2 more patients a day or maybe working 5 days a week. Survey Business people in the area, some work 7 days a week.
Granted Doctors have a high stress level, I'm sure, but you should realize you are not alone. There are far more stressful vocations out in the real world, as I am sure you can attest to, as you have probably provided your services in addressing the resulting issues. One thing I am sure of though,I bet you would ask any one that has their own business and they would love to be able to say they pocket 45% of their income after business expenses. I bet you also can check the records and you will see how many businesses go bankrupt. As you said "Healthcare is not a right"
True, but remember people also have choices!!!
After reading all the comments on this subject, I have just one comment. To all the Doctors that are unhappy with their current status, maybe you should apply for a Hospital Administrator job. Better pay, less stress and no business overhead, and you probably would not even be on call.
You wouldn't even have to worry about a mal-practice suit. But then again we would not have this interesting blog. Or would we???
Just finished a summer reading entitled "Marker". At the end of the book, Robin Cook, a physician states that he has always been against health insurance with exceptions of catastrophic care and help for the indigent. However, he has now done a 180 and is recommending pooling the risk for the entire nation. This would be a gov supported, non-profit, single payer plan. As an afterthought, Cook suggests that we also need less high-priced administrators and better pay and optimum working conditions for the nurses in the trenches. What do you think about this idea--Healthblogger? I stayed with a Doc surgeon over in England that had to do about 10 gallbladder surgeries a day.
The battle insurers face is that MDs maximize profits by ordering more procedures. There needs to be a way for MDs to make more profit by ordering less procedures.
Whats wrong with a 45% profit.
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