“If you’re not getting ready for some pretty ugly fights with large healthcare systems, then you’re saying to me, ‘My company makes too much money, and I want to spend it on healthcare,'” said Paul Hain, MD, president of BCBS Texas’ North Texas market.
Dr. Hain told about 500 gathered for the Dallas-Fort Worth Business Group’s recent annual conference, which includes large employers providing health coverage for nearly 800,000 workers, that unless employers side with their insurers in negotiations with providers, they are resigning themselves to paying as much as health systems want with whatever restrictions they desire.
The disputes have less to do with reimbursement rates than restrictions over the insurer’s desire to direct patients to lower-cost facilities, Dr. Hain said. Those restrictions, vehemently opposed by Blue Cross, would allow hospitals to charge more for all health plan members, he said.
“Stand with your carrier” in these arguments, Dr. Hain advised.
“If you cut and run, you’re essentially saying, ‘I don’t care how much hospitals and doctors raise prices. My budget is gonna take it,'” said Dr. Hain. “I don’t think anybody has that luxury anymore.”
The Dallas area has some of the nation’s highest health spending, according to the Morning News.
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