The article first focuses on reduced payments from UnitedHealth Group. Contract amendments sent to some New York City physicians are bringing UnitedHealth’s rates closer to the state’s Medicaid program, according to the report. WellPoint is also mentioned. One physician declined a contract from the payer’s Anthem unit, calling the rates “not what a reasonable person would consider acceptable.”
The WSJ report reinforces anecdotal observations about payments under the exchange plans so far. Christopher Kerns, managing director with The Advisory Board Company in Washington, D.C., says he’s been hearing commercial rates under the typical exchange plan are a single-digit point above Medicare rates, which generally cover 85 to 95 percent of fully allocated costs. The typical employer-sponsored commercial plan typically covers about 130 percent of those costs.
To read the rest of the article, visit Becker’s Hospital Review.
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
