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Amy Umble is health reporter for The Free Lance-Star

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Consultant occupies middle ground between Anthem and Mary Washington

Dr. Steven Mussey's cartoon appeared in the Free Lance-Star on Dec. 18.

One of the new wrinkles in the contract dispute between Mary Washington Healthcare and Anthem Blue Cross Blue Shield is the use of a consultant.

Mary Washington has hired Crowe Horwath, one of the nation’s largest public accounting and consulting firms, to represent it during contract talks. Crowe Horwath, based in the Nashville area, is earning a flat fee for its work, said a hospital official.

Unlike earlier negotiations between Mary Washington and Anthem, this one features no direct talks between the two. All conversations go through Crowe Horwath, said Scott Golden, Anthem spokesman.

Golden said that Anthem has dealt with consultants before during contract negotiations with hospitals, but that this is the first time it’s dealt with Crowe Horwath.

“Dealing with the consultant makes it more cumbersome than it probably needs to be,” Golden said. “Hospitals may like to use these guys, but from our standpoint, when we can’t deal directly with the hospital, we don’t know if the hospital is getting everything we’re providing them.”

Eric Fletcher, senior vice president for marketing and communications for Mary Washington, said it’s common for hospitals to use consultants, and that Mary Washington has used them in the past.

“The third party brings a tremendous amount of knowledge about what is a fair level of reimbursement across a region, a state and even across the country,” Fletcher said.

Fletcher also said that the use of a consultant has not hindered the contract talks.

“The reason negotiations haven’t been fruitful to this point is that Anthem has yet to move from its original position or counter any of the five proposals that we have sent them,” Fletcher said.

Mary Washington officials decided this week to change their third-party strategy a bit. They’ll travel to Richmond tomorrow for a face-to-face meeting with Anthem representatives.

“We’re trying everything,” Fletcher said. “We do not want to go out of network. However, we want to be paid fairly.”

(For more on the contract dispute, see the story soon in the paper. A prior blog post on the topic can be found here. It contains a link to other posts. Mary Washington has Anthem information on its website here. Anthem has a Mary Washington page here.)