County’s siding with HCA becomes more clear now

Maybe I’m looking at this wrong. If Anthem negotiates lower prices from HCA, one might presume that it will benefit the Spotsylvania County citizens who have Anthem health insurance.

right?

Sounds to me that the BOS would just prefer that a deal be done so the staff isn’t lefy high and dry.

Based on Jim Hall’s piece, Anthem and HCA don’t appear to be in the same universe. HCA says it just wants the payments Anthem gives Mary Washington; Anthem says HCA is asking for rates higher than MW.

Bizarre.

Again, if both sides seems to be amenible to HCA getting the same deal MWH gets, why not just have that be the meeting point?

I don’t think it is untoward to have the BOS ask people to call to request a solution. They’re not asking for people to call and berate Anthem or say anything bad. Just to find a solution- which IS in the public’s best interest. Btw, if the rates Anthem forces are so low HCA can’t attract docs to compete with MWH, it’s not a good thing for Spotsylvanians.

HCA is covering Anthem customers’ costs to get them down to their effective copay in the interim. I think that speaks volumes about where they are coming from.

yeah….. Steve and DJ …. this is TAXPAYERS money spent to provide health insurance for county employees – right?

what’s the best deal for taxpayers here?

not to be too harsh on “journalists”, the situation is pretty widespread with most consumers to include elected officials and the root cause of the problem is that most consumers of health care do not really care what the services cost nor who is providing them, much less shop around for the best value because with the way we “do” insurance now days, you are either “covered” or you or not.

So the average person not only has no clue what HCA would charge for an MRI nor what MWC would charge nor how those prices compare to other providers much less engage in normal consumer behavior of refusing to pay more for something than you should.

Just FYI – MRI’s in other countries cost about 1/10th what they do in this country – using the same exact equipment.

and finally.. I find it ironic that the BOS and the County are asking taxpayers to talk to Anthem about what?

About keeping their premium prices as low as they can so as to save their employees and taxpayers money?

Nope.

They apparently want Anthem and HCA to agree to whatever MWC and Anthem have agreed to – a very UNCOMPETITIVE, and anti-capitalist concept that our two erstwhile Republican commentators here have had ZERO to say about it.

How about some Republican words on this situation guys?

What would Republicans do about this if they were in charge?

Dan, Spotsylvania Regional Medical Center is not negotiating for doctors, it is negotiating rates for the care provided within the hospital by nurses, technologists, aides, and related ancillary services. Physicians are independent practitioners paid by third parties – like Anthem. Your article misrepresents this fact by stating “HCA would obviously want the best pay rates for its doctors.”

I stand corrected: HCA wants the best rates for its service providers.

But is it out of the realm of possibility that the doctors have complained to HCA about Anthem?

Give me a break.

How about this: One side has one story. Another side has another story. How about someone step up and tell the truth. These are private entities and there is nothing I can request through the Freedom of Information Act that would possibly shed some light on this.

And secondly, it is not my beat. I cover Spotsylvania County government and not the medical beat.

The clarification you are all pointing out really doesn’t affect anything. Whether it is a doctor HCA is pushing for or its own staff, someone is not giving the full details of what the problem is.

Didn’t one side say they were offering rates that were “comparable” to what MWH gets while the other side side said they wanted what MWH gets? “Comparable” is subjective. Is comparable a 15% difference in rates, a 10% difference, or what?

But Steve Thomas says that since Anthem is a monopoly that government should get involved?

That’s strange… if you ask me. I don’t have Anthem and I have no clue what my company has “negotiated” with HCA… but I strongly suspect they’ll pay the same thing that they pay for MWC or any other hospital provider – as …. now pay attention here Steve – as dictated by the Federal Government as a requirement of any plan offered to govt employees including Congressman.

So.. Steve – it’s the Federal Government that wanted to expand this rule to all providers as part of health care reform.

so .. should the govt be involved in this issue or not?

I keep asking and I’m not getting a firm answer here.

BTW – “near monopoly” is also a weasel-word as there are a bunch of non-Anthem providers in the area…. but I’ll play along and pretend for Steve’s sake that it is ONLY Anthem so I can then ask Steve – does this situation justify the big, bad, incompetent, corrupt government intervening ?

Larry…you’re burning the candle at both ends, with no where else to go. WHY? It doesn’t serve a useful purpose and only the health care community can wage this battle for market share. Face it, you’re becoming nothing more than a distraction and we are the ones worse off for your single minded pretense on the subject of solutions. Can’t bring myself to say “back off”, you’re headed in the wrong direction and it appears all you want to do lately is pick fights. This is something you’ll have to decide for yourself.

Marty – the only thing I am advocating here is that folks use their heads in recognizing that as big as Anthem is that there are other providers because so many of our residents are Fed govt employees or active duty service folks with plans also.

To ask why this is only a problem with Anthem and not Tricare or Medicare or the dozen other plans that Fed Govt employees have.

and then of course – to also recognize the irony that it is the county itself that is enabling Anthem to have “near monopoly” status since they are the ones who have chosen Anthem for their county and school employees.

Then finally.. to recognize how the Fed govt steps in and tell’s it’s contracted providers that they cannot do this kind of stuff while the county tries to get folks to “call”.

Why would the county not simply say – as a contract provision – that whoever they select to be the provider – has to provide the same reimbursement no matter whether it is HCA or MWC – you know..like the Feds do.

Apparently, negotiations are continuing….or have they stopped with no resolution???

Steve, where did you get that info? Based on Jim Hall’s last story, HCA said it would do its best to minimize costs, but there is no guarantee.

If Spotsylvania Regional does not join Anthem’s network by the time it opens, patients with Anthem insurance would be “out-of-network” there and could face higher costs, depending on their plans.

Tobin said the hospital promises to minimize this impact, if it occurs.

“They can come to our hospital, and we will work with them to make sure that there is no financial penalty,” he said.

Opinionstoshare, that was a quote from Jim Hall’s story before the hospital opened. SOrry

Again, this is from Hall’s story:

“If Spotsylvania Regional does not join Anthem’s network by the time it opens, patients with Anthem insurance would be “out-of-network” there and could face higher costs, depending on their plans.

Tobin said the hospital promises to minimize this impact, if it occurs.

“They can come to our hospital, and we will work with them to make sure that there is no financial penalty,” he said. “