Health care childishness

Tim Rice of Moses Cone Health Systems and Bob Greczyn of BCBS North Carolina are duking it out on the editorial pages of the N&R.  And it ain’t pretty.  One thing that struck me was the miles of separatation represented in these two statements…

Rice: “…BCBS has fallen far behind other insurance companies and we simply cannot continue to accept these low payments. Over the past 10 years, we’ve become a bargain for BCBS because our charges are 45 percent to 50 percent less than our peer hospitals in the state.”

Greczyn (link fixed): “How could an X-ray at one hospital cost six times as much as the same service at another facility less than 50 miles away?  …That’s just one of the things that puzzled us as we examined the recent demand by Moses Cone Health System for higher fees for hospital services.”

Either one of them is not telling the truth or they are speaking different languages in their now-stalled negotiations.  One thing’s for sure, though: I’ll be the one getting screwed here unless the two organizations get their stuff together.

As a customer of both Cone Health and BCBS I say its time for some serious compromising.  Supposedly both entities are run by adults charged with looking out for the public good, but this feud makes them both come across to me as spoiled brats.

If it turns out that Jinni has to travel all the way to High Point or Winston Salem to recieve ongoing follow-ups for her breast cancer, we are going to be some very pissed-off customers.

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13 Comments

  1. Posted August 10, 2007 at 8:26 am | Permalink

    The salaries of each man:

    Bob Greczyn, 2006: $2.5 million

    Tim Rice, 2005: $703,246

  2. Posted August 10, 2007 at 8:28 am | Permalink

    Having seen the pricing of BCBS, and knowing that they’re a not-for-profit corporation, I don’t understand why they’re just as competitive on the pricing for premiums (ie. it’s really not that great of savings compared to say… Aetna) but yet according to Cone Health, they’re not paying as much over?

    Sounds to me that someone is pocketing a lot in the middle between the consumer, and the health care provider.

  3. debora mauser
    Posted August 10, 2007 at 8:35 am | Permalink

    I received the same letter in the mail, saying that Cone has given $90million in free treatment and that they just couldn’t expand without more money. Now why should those of us who pay, have to pay more? It is not surprising that the two sides view this polar opposites. How can any large company feel that BCBS is the best for their employees if there is no hospital in the county that is a ‘preferred provider’
    That’s what we get for letting Cone have a monopoly.-Competition is good!

  4. Posted August 10, 2007 at 9:26 am | Permalink

    I’d like to see Greczyn back up his claims with some data. What I find contradicts him.

    Comparative costs:
    (Data is from http://www.vimo.com)

    Removal of spleen:

    Moses Cone: $22,000 — Of hospitals in a 60 mile radius, 3 are more expensive, 0 are less expensive.
    High Point Regional: $22,700 – $27,400 — Second lowest

    Femur Fracture:

    Moses Cone: $4,500 — Of hospitals in a 60 mile radius, 6 are more expensive, 0 are less expensive.
    High Point Regional: $5,400 – $6,200 — Second lowest

    Colon or rectal cancer (non surgical care):

    Moses Cone: $4,100 — Of hospitals in a 60 mile radius, 2 are more expensive, 0 are less expnsive.
    High Point Regional: $5,300 – $7,400 — Second lowest

    Appendectomy:

    Moses Cone: $7,700 – $9,700 — Of hospitals in a 60 mile radius, 2 are more expensive, 4 are less expensive..
    Randolph Hospital: $5,300 – $7,400 — Lowest

    Food Poisoning (non-surgical):

    Moses Cone: $6,200 – $7,600 — Of hospitals in a 60 mile radius, 8 are more expensive, 1 is less expensive.
    Morehead Memorial Hospital: $5,800–$6,600 — Lowest

    General Operating room procedure for multiple significant trauma:

    Moses Cone: $35,100–$39,700 — Of hospitals in a 60 mile radius, 1 is more expensive, 0 is less expensive.
    Baptist Hospital: $56,200–$78,700 — Highest

    Rib fracture:

    Moses Cone: $4,400–$6,100 — Of hospitals in a 60 mile radius, 2 are more expensive, 5 are less expensive.
    Memorial Hospital of Martinsville: $3,800–$5,400 — Lowest

  5. Posted August 10, 2007 at 2:38 pm | Permalink

    David, not that it affect me, but your link to Greczyn’s piece is screwed up. Thanks.

  6. winstongator
    Posted August 10, 2007 at 3:15 pm | Permalink

    “Blue Cross and Wake Forest Baptist Medical Center had a similar dispute in 2005. Read the stories below to see how the two sides settled that dispute.”

    http://www.wfmynews2.com/news/2yh/article.aspx?storyid=87592

  7. jwg
    Posted August 10, 2007 at 10:52 pm | Permalink

    I don’t have the paper in front of me, but didn’t Mr. Rice say that the payments from BCBS “barely cover our costs”? To paraphrase, “we’re not making enough profit from BCBS to cover losses elsewhere”?

    Roch, are those “Suggested Retail Prices” or “street prices” for an insured patient (and which insurance)?

  8. Posted August 11, 2007 at 7:51 am | Permalink

    JWG, those are the “negotiated” rates.

  9. jwg
    Posted August 11, 2007 at 8:18 am | Permalink

    Roch,

    Thanks for the clarification.

    Is the ‘negotiated rate’ the same for all carriers i.e. is Cone asking BCBS to match United HealthCare’s reimbursement rate?

    Winstongator,

    I read the articles and they do not explicitly say that BCBS increased their reimbursements to Baptist. It merely says that the parties reached an agreement (not giving any details) and that Baptist had been loosing millions “because of what they claimed were low reimbursement rates by BCBS”. For all we know from the article, BCBS sent in a team of efficiency experts and saved Baptist millions, negating the need for higher reimbursements (although I doubt that’s what happened).

    Do you have any details on the reimbursement rates before and after the agreement?

  10. Posted August 12, 2007 at 1:47 am | Permalink

    I blogged on the mess in Winston as it happened. It set my surgery back a year (it’s not breast cancer, but corrective surgery that considerably lessened the tirggers for my trigeminal neuralgia was a fairly big deal to me). Virtually no one in the GSO blogosphere talked about it or cared.

    Where was the blogging calvary when ProCare was trying to create a buzz by exposing BCBSNC’s “non-profit” business secrets? Blue Cross literally sued ProCare out of the blogosphere.

  11. Posted August 17, 2007 at 8:35 pm | Permalink

    Ummm.. there’s a big difference between “not-for-profit” and “nonprofit”. Two different federal designations. BCBS is a not-for-profit.

  12. Posted August 29, 2007 at 1:19 am | Permalink

    A “non-profit” then. Whatever.

    And here’s why: The public’s perception is what matters. And in either case (“non-profit” or “not-for-profit”, the public thinks that these kinds of entities are in the game to serve the public . . . NOT to pull in monster profits cushioned by tax breaks (and under-the-cover of “public service)”.

    Nothing could be further from the truth . . . ESPECIALLY with Blue Cross.

  13. David Colin
    Posted September 23, 2007 at 10:37 pm | Permalink

    Roch

    Look the costs quoted are if you walk in off the street I think ( correct me if I’m wrong).

    What cost is negotiated with the insurance companies?

One Trackback

  1. By Piedmont Publius » Blog Archive » Dueling CEOs on August 10, 2007 at 8:47 am

    [...] Hoggard weighs in, saying he’d be one pissed off BCBS customer if his wife Jinni had to travel to HP or W-S for follow-up breast cancer treatments. I wouldn’t blame him. But I believe Cone and BCBS will somehow work things out. [...]