Survey on Insurance Carrier Contracts – 60% Reduction in Rates?!

This was copied from an email sent by ASA today.

We have some early data from last week’s survey of groups who have been dropped mid-contract by their insurance carriers in the last six months. We created the survey because we suspected carriers are doing this as a tactic to help get insurance-friendly surprise medical billing legislation passed. As of this writing, there were 55 responses representing 20 practice groups in 15 states:

• More than 60% said they’ve had contracts terminated during this period
• Over 30% experienced rate lowering (both mid-contract and at renewal)
• 50% of practice groups experienced contract termination or rate lowering
• 50% of states represented in the survey were affected
• United Health was the insurer most associated with these changes (79%), but Priority, Cigna and BCBS were also reported.
• Multiple respondents reported insurers quoting surprise medical billing legislation as the reason for their actions.

Here are a few telling comments:

“United has informed us that we will be subject to a 60% reduction.”

“Aetna has also threatened us over state and national legislation regarding out of network billing during contract negotiations.”

“Cigna representative was previously employed by Anthem, so appears to be price fixing to a lower level as well as mentioning surprise billing.”

One ASA member said they shared last week’s MMO with Tennessee Sen. Lamar Alexander, who responded with his interest in seeing the results of our survey – so we are definitely being heard!