Health insurers mum on practices
Dom
and doctors are paid up to three times as much as others for the same
services."
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The Boston Globe 10 December 2009 Page B5
Health insurers mum on practices
State regulators' get few answers about talks with providers
By Kay Lazar, Globe Staff
Executives from some of the state's leading health insurance
companies, facing an unusual public grilling from state regulators
yesterday, refused to answer key questions about why some hospitals
and doctors are paid up to three times as much as others for the same
services.
But some of the company officials acknowledged that the affordability
of coverage for employers and their workers is not a priority in
negotiating contracts with health care providers. Instead, they said,
provider payments are based on fierce competition among hospitals and
doctors in some areas of the state, as well as employers' insistence
that a particular hospital or physicians' group be included in their
plan.
The testimony was part of a monthlong probe by the state Department of
Insurance into the reasons for disproportionately high health
insurance rates paid by small businesses; but the agency has expanded
its investigation to determine what is behind the soaring increases in
insurance costs overall, including the large disparities in payments
to providers.
In at least a half-dozen instances, executives from the state’s
second- and third-largest insurers--Harvard Pilgrim Health Care and
Tufts Health Plan--declined to answer regulator' questions. They
explained their companies had signed confidentiality agreements with
certain hospital or physician groups that prevented them from
disclosing the information publicly because doing so would put the
insurers at a competitive disadvantage.
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