Hospitals Worried About Impact of Insurance Exchanges

by Mark Friedman  on Monday, Oct. 7, 2013 12:00 am  

Arkansas Blue Cross & Blue Shield is one of the four companies that will sell insurance through the Health Insurance Marketplace in Arkansas. The others that have signed up are National Blue Cross Blue Shield Multi-state Plan; QCA Health Plan of Little Rock, which does business as QualChoice of Arkansas Inc.; and Celtic Insurance Co. of Chicago, through its subsidiary NovaSys Health.

Roberts, from White County Medical Center, said that two of the four plans negotiated payment rates with the hospital “in good faith. And they’re not a lot different from the payments that we currently have with those plans.”

But the other two companies, which he wouldn’t identify, simply told White County Medical Center how much they would pay. There wasn’t any negotiation, Roberts said.

“And those rates are somewhat lower than what we’re currently receiving from those plans,” he said.

The private reimbursements will be “a little bit higher, but not a lot” higher than the reimbursements currently being paid by Medicare.

UAMS had more revenue last year than any other hospital in the state (see list, Page 26), but Townsend said even UAMS didn’t have much negotiating leverage.

“They were pretty set on the rates they were going to pay,” she said.

But she said the rates for patients insured through the exchange will only be a few percent lower than the carriers currently pay the hospital.

Dealing With Medicare Cuts

To deal with stagnant revenue from Medicare, Roberts said White County Medical Center is examining all costs to save money “while maintaining or improving quality” of health care.

For the fiscal year that ended Sept. 30, it eliminated the equivalent of 40 full-time positions.

“All of this evaluating is coming about not just because of the insurance, but because of all the changes that are currently occurring in health care,” Roberts said.



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