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Hospital Views of Payers

By May 14, 2014Commentary

ReviveHealth, a leading health care public relations and communications firm, has issued its 8th annual survey results on hospital system views of payers.  About 200 hospital system leaders were surveyed.  (Revive Report)   The questions asked were aimed at understanding the level of trust between these entities.  The questions included if the payers honored commitments, was accurate and honest about intentions and balanced the payer’s interest with the hospital’s.   On this basis trust is very low, with hospitals concerned about how long it takes to get paid, payment rates and network inclusion issues.  Of course, payers similarly are concerned about what they have to pay hospitals.   Over 90% of the health system respondents had contracts with UnitedHealth, Cigna and Aetna and almost 90% contracted with Blue Cross plans.  Over 50% of respondents thought their hospital was a must-have in the payer’s network.  No plan scored well with the health systems; the average score out of 100 was 53.  Cigna, Blue Cross, Coventry and Aetna had above average scores; Wellpoint, Humana and UnitedHealth were below average.  Cigna had the highest overall score at 63;  UnitedHealth was worst at about 41.  In regard to honesty, Cigna was highest at 66, UnitedHealth was worst at about 43.  On fairness, Cigna again was highest at 57 and UnitedHealth brought up the rear again at a dismal 36.

These respondents thought consumers had the highest level of trust in the Blue Cross plans, 66% picked those entities and 47% thought UnitedHealth was the plan least trusted by consumers.  Thirty-seven percent thought the Blues plans were the best at dealing with hospitals, only 11% thought it was the worst.  On the other end, 42% considered UnitedHealth the worst overall at dealing with hospitals, only 6% viewed it as the best.  About half of respondents thought the Blues were the promptest payers, 31% considered UnitedHealth the worst at paying promptly.  UnitedHealth was also viewed poorly in negotiations, with 46% saying it was the worst at negotiating honestly, while the Blues again had the highest percent viewing it as having the best reputation for honest negotiating.  UnitedHealth also was viewed as the worst at denying claims, while the Blues again had the highest favorable rating in this regard.  Interestingly, Aetna was viewed as having the highest actual outpatient and inpatient payment levels, while the Blues pay the lowest amounts.  Most hospitals feel their largest payer pays enough that they would be profitable if that payer represented all their commercial business.  Most hospitals have quality criteria in their contracts and they think these provisions represent upside, not risk.

The negatively-rated payers (are you listening UnitedHealth) would likely justify their negative status by saying it reflects them doing the best job to protect their employer and consumer customers, but sooner or later this negative a perception will have a marketing, revenue and profit effect.

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