Hospitals Rank WellPoint as "Worst Payor" for Second Straight Year

The award for least-favorable health insurer overall for the second consecutive year went to second-largest, for-profit insurer WellPoint, according to the 2013 National Payor Survey conducted by communications firm ReviveHealth.

A total of 373 hospital CEOs, CFOs and payor relations executives who represent about one-third of U.S. hospitals' payor contract negotiations responded to the survey between February and March. The survey was conducted in partnership with Catalyst Healthcare Research and The Godbey Group.

Below are some of the survey's major rankings and findings.

Best and worst overall. WellPoint, which scored an overall favorability rating of 16 percent from hospital executives, runs plans in 14 states, including non-profit Anthem Blue Cross in California. In contrast, independent Blue Cross Blue Shield plans tied for most favorable health plan with fourth-largest, for-profit insurer Cigna, both earning a score of 49 percent.

Best rates. For the third straight year, independent Blue Cross plans ranked worst in payment rates, and Aetna ranked first, inching out Cigna.

Best and worst to "deal with." Though tied for overall best payors, independent Blue Cross plans beat Cigna handily for best to "deal with," scoring 30 percent of hospital executives' vote versus 19 percent Cigna earned. UnitedHealthcare continued its streak for a third year ranking worst to deal with, followed by WellPoint. ReviveHealth CEO Brandon Edwards called this the "trust factor," made up of perceived qualities like honesty and expediency, which determine providers' perception of payors regardless of payment rates.

Mr. Edwards applauded new WellPoint CEO Joe Swedish's background as former CEO of Livonia, Mich.-based hospital system Trinity Health, but added, "He's got to turn an aircraft carrier, and that takes time," according to a news release.

Payor rate gaps by size. The survey results showed the largest gap in payment rates between the largest payor and smaller plans in the seven years the ReviveHealth survey has been conducted.

Hospital strategies. Two in three hospitals have set up a wellness program for employees, making it the most popular hospital payor strategy, followed by clinical integration at 41 percent, accountable care organizations intentions at more than 50 percent, direct contracts with employers at 20 percent and preparations planned or under way for tiered and narrow network plans for slightly more than half.

More Articles on Hospital-Payor Relationships:

Portsmouth Regional Hospital Enters Anthem's Medicare Advantage Network
15 Recent Issues Between Hospitals and Payors
Minnesota Hospitals Denounce Blue Cross Payment Changes

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