Author: Beverly K. Philip MD FACA, FASA
President of ASA
Monday Morning Outreach
We now have three weeks’ worth of data from our insurance carrier survey, where we’re learning about unilateral reduction in payments and contract terminations from some of you.
We will use this data to advocate on behalf of our many members and the patients we serve who have been adversely affected by these actions. Our efforts will be directed to lawmakers and regulators, along with communications directly to the carriers identified by our members, including United Healthcare, Cigna, and regional carriers.
Here is the latest report:
We have had 120 responses from 31 states. Group sizes ranged from single digits to thousands – 53% of respondents said they were not part of a large national practice and 47% said they were.
- 73% reported a termination mid-contract within the last year
- 54% said an insurance carrier notified them of a non-renewal within the last year
- 53% had an insurance carrier lower their contract rate mid-contract within the last year
- 52% said an insurance carrier lowered their contract rate at renewal of the contract
- 70% faced a situation in which a payor gave an ultimatum between accepting a rate reduction or forcing a contract termination prior to the end of a contract
Here are some respondent anecdotes shared so far. We’ve edited them to preserve anonymity:
- “We have been approached by insurers in multiple markets looking to reduce our rates. Policy changes in the Midwest market are also reducing how CRNAs are paid.”
- “An insurance company is changing to the CMS method for time calculation, which in effect lowers our rate by 4%.”
- “An insurance company terminated our agreement mid-contract and demanded a 30% rate cut to renew and continue. This during COVID when they (along with all carriers) were making record profits and we were among the front-line workers for lines and airway management.”
- “They are aggressively drawing a line on an Excel spreadsheet and eliminating the top 1/3 of their contracts. This is not only in anesthesia, but also ER, radiology, and pathology. We need to coalesce with these groups and fight back.”
- “In the midst of contract negotiations in which the insurer demanded a 50% reduction in reimbursement, they abruptly cancelled the contract and declared us out of network in a unilateral decision.”