CT News Junkie | Calls for Mediation Grow Stronger As Hartford Healthcare, Anthem Impasse Continues

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Calls for Mediation Grow Stronger As Hartford Healthcare, Anthem Impasse Continues

by | Nov 16, 2017 3:32pm
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Posted to: Health Care, Insurance, Jobs, Labor, Legal

Courtesy of Hartford Healthcare's home page

Hartford Hospital

HARTFORD, CT — Consumers, regulators, the governor, and the state in general are getting restless over the seven week impasse between Hartford Healthcare and Anthem Health Plans.

The two sides have been unable to reach an agreement over how much Hartford Healthcare should be reimbursed for medical services it provides to Anthem’s customers. As a result of the impasse, patients have been unable to see their Hartford Healthcare providers unless they are willing to pay out-of-network prices and facility fees.

“I think the situation with the hospital and the insurance company is a difficult one,” Gov. Dannel P. Malloy said. “I understand the hospital is looking for a 6-percent increase per year, which would raise the cost for us … to closer to 20 percent over a three year period of time. That’s pretty outrageous to tell you the truth.”

Anthem Health Plans is the health care administrator for most state employees and retirees. The state is self-insured.

“I would urge these folks to avail themselves of the mediation process,” Malloy said. “I would also urge people, if they’re unhappy with the hospital system, that they find a different system.”

That’s easier said than done however for some residents who live in parts of the state only served by the network.

The Hartford Healthcare network of providers includes Hartford Hospital, Midstate Medical Center, Backus Hospital, Windham Hospital, The Institute of Living, Jefferson House, Jerome Home, Natchaug Hospital, Rushford, Hartford Healthcare Medical Group, Hartford Healthcare at Home, Hartford Healthcare Rehabilitation Network, and Southington Healthcare.

It also recently acquired, as of yesterday, Charlotte Hungerford Hospital in Sharon. However, that hospital won’t be impacted by the contract impasse because Charlotte Hungerford’s current contracts with insurers will remain in place until they expire.

Anthem Health Plans has called for a mediation session.

In a letter earlier this week to Hartford Healthcare, Jill Hummel, president of Anthem Blue Cross and Blue Shield in Connecticut, restated its desire to reach a swift resolution through non-binding mediation.

“The offer of Anthem to go to a mediation process was pretty darn impressive,” Malloy said. “I think it’s pretty bold and unthinking for the hospital system not to avail themselves of that service.”

Hartford Healthcare has declined.

Christine Stuart / photo

Gov. Dannel P. Malloy

Hartford Healthcare CEO Elliot Joseph said in a message to its customers that Anthem is distracting the public from the real issues regarding the contract dispute.

“We have shown during negotiations that our analysis shows Anthem invests 20 percent less here than it invests in New Haven and in other states,” Hartford Healthcare states. “So much less, in fact, that if Hartford HealthCare continues to accept these low payments, we won’t be able to sustain the breadth of services we currently provide.”

Elliot added that Hartford HealthCare isn’t the only one being impacted.

“Anthem’s members — our patients — are suffering from higher premiums and a shrinking network of providers because of Anthem’s actions,” he said.

He said Anthem’s profits, which were reported at $746.9 million in profits in the third quarter of this year, “don’t stay in Connecticut; they are shipped back to Anthem’s headquarters in Indiana.”

He said unlike Anthem, Hartford Healthcare’s investment “stays here.”

A group of consumers, including Connecticut Healthcare Advocate Ted Doolittle, said the impasse is impacting the health of Connecticut’s residents.

He said there’s a “sense of betrayal” when the commercial plan your employer or you chose won’t allow you to see the doctor who was in your network when you signed up.

He said consumers in certain areas of the state — such as the northeast corner — don’t have very few choices when it comes to healthcare.

“With great power comes great responsibility,” Doolittle said.

He said he believes they should voluntarily enter into mediation.

“This has gone on far too long,” Doolittle said.

Then “the legislature should set up some guardrails,” to protect consumers from “future contract outages,” he added.

Frances Padilla, president of the Universal Health Care Foundation, said the acquisition of multiple providers and health care systems leaves consumers with nowhere to go in these disputes.

“The struggle between these big hospital systems and Anthem is like two sumo wrestlers suffocating the consumer between them,” Padilla said.

She said the legislature needs to step in and protect the consumers from these disputes, which are likely to increase in frequency.

Tom Swan, executive director of the Connecticut Citizens Action Group, said the underlying problem is the “corporatization of healthcare” and the need to grow “bigger and bigger.”

He said he supports mediation, but he wants Doolittle and state Comptroller Kevin Lembo, who administers the state health employee plan, at the table on behalf of consumers.

Presser on Anthem and Hartford Healthcare impasse with Frances Padilla, president of the Universal Health Care Foundation, State Healthcare Advocate Ted Doolittle, and Tom Swan, executive director of the Connecticut Citizens Action Group

Posted by CTNewsJunkie.com on Thursday, November 16, 2017



The legislature’s Insurance and Real Estate Committee will hold hearings in less than two weeks on the issue.

The forum will begin at 10 a.m. Tuesday, Nov. 28, in Room 2C of the Legislative Office Building in Hartford. Representatives of the two companies will be invited to speak before the public. The public portion of the hearing is expected to start at noon.

“The inability of these companies to reach an agreement has had a significant impact on many Connecticut families for the last seven weeks,” Rep. Sean Scanlon, D-Guilford, said. “I think the public deserves answers as to why this dispute is still ongoing and I look forward to helping them get those answers.”

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