Cut/paste style messages may suggest a coordinated strategy against health systems
Across the country, healthcare providers continue to feel the crushing weight of inflation, increased labor and supply expenses, and other cost pressures. To survive, most hospitals have gotten used to a long, steady diet of cuts and control costs. But they can’t get there on the expense side of their ledger alone, so they are asking insurance companies for a raise.
Sounds like a reasonable request, right? Well, not to Anthem.
Instead of considering the environment in which hospitals must operate—whereby commercial reimbursement is the only way to find margin to reinvest back into improving patient care—Anthem has been engaged in a steady stream of public skirmishes during negotiations with health systems across the country. And its tone and tactics have become increasingly confrontational. This, even though what health systems are asking for amounts to little more than a cost-of-living adjustment to better care for patients.
In these skirmishes, Anthem has sent letters, launched websites, and published social content, complaining that the rates various health systems are requesting are too excessive. They often offer a convenient, neatly plucked rate or two as an example, but seldom draw back the curtains fully to show a full and complete picture.
Such assertive tactics often work. Many health systems, who are under-resourced and unprepared to withstand such a public back-and-forth, acquiesce. Instead of standing up for themselves and by extension the patients they care for, they reluctantly accept rates that are lower than what they might need.
Now, on top of the traditional tactics that pop up around Anthem negotiations, we are witnessing the emergence of a new and somewhat more creative tactic: the venerable opinion piece.
A number of opinion pieces have recently been published in hyper-local or small news outlets across the country, lambasting the health system and vigorously defending Anthem in the negotiation.
From a distance, such opinion pieces may not raise alarm. But a funny thing happens when you read them more closely and compare them side-by-side. They sound remarkably similar, with identical phrasing, similar anecdotes and even the same talking points.
Shall we take a closer look?
At issue are two Anthem negotiations with two totally separate systems: Mercy Health, a faith-based system in Missouri and Memorial Sloan Kettering, the world-renowned cancer center based in New York City. Yet here we are, with eerily similar opinion pieces published in Missouri Times and the Queens Daily Eagle wagging a finger against each healthcare provider, using the same set of slick, boilerplate talking points found on Anthem’s own websites.
These healthcare providers couldn’t be more different from one another, from the services they provide, to their size, their scale and the markets they serve. And in both cases (and with Memorial Sloan Kettering in particular), these health systems seem to be underpaid and deserving of a proper raise to keep up with rising costs. Yet the arguments (and even the specific phrases used) in each of the opinion pieces are virtually cut and paste.
Now, is it possible for two people a thousand miles apart to independently – and without prompting – write eerily similar opinion articles passionately defending a highly profitable and publicly traded insurance company and bashing a health system? Sure, it’s possible. But is it likely? Who knows.
What we do know is this: large insurers like Anthem are increasingly comfortable being confrontational and aggressive in negotiations with health systems, coming out with guns blazing when health systems ask for a raise. Yet they seem to have no trouble hiking up their insurance premiums year after year.
The insurers’ vast scale also gives them significantly more power and leverage than the hospitals they negotiate against, who in comparison must negotiate reimbursement rates with a much narrower view of rates compared to what they are really worth in the marketplace. The likely outcome in such a mismatch that the undersized health system settles for less than it should, while the giant Anthem pockets the difference.
