Insurance Exec: ‘The Consumer View Isn’t Just the Hospital View’
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WellPoint’s efforts to control medical costs include “more aggressive” contract negotiations with health-care providers and the somewhat euphemistically described medical management levers, according to a Thomson Reuters transcript of the insurer’s call with analysts.
The Health Blog caught up with Wayne S. DeVeydt, WellPoint’s executive vice president and chief financial officer, to ask for more details. DeVeydt said that some hospitals have been seeking increases of as much as 50% in payments from insurers. Employers are increasingly willing to consider allowing the insurer to drop a hospital from its local network of providers if the hospital’s rates cant be brought to an acceptable level and there are other options in the community, he said.
DeVeydt added that WellPoint is getting more support from employers if a hospital complains to state regulators that the insurer isn’t providing an adequate network for members. “Were trying to make sure that the regulator knows the consumer view isnt just the hospital view,” but also the employers view, he said.
Employers are also increasingly open to various cost-saving tactics, including pre-authorization requirements, Mr. DeVeydt said. As an example, he referred to efforts to avoid unnecessary imaging scans.
WellPoint’s fourth-quarter profit jumped on a one-time $3.8 billion gain […]
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