News From Terre Haute, Indiana

Local & Bistate

June 30, 2009

Union Hospital: ‘All signs’ indicate no deal with Anthem

TERRE HAUTE — Union Hospital Health Group is warning patients that “all signs” indicate it will not remain part of the Anthem Blue Cross and Blue Shield health insurance network after July 31.

In a letter dated June 30 and posted on the hospital’s Web site Tuesday, Union Hospital president and CEO David Doerr stated negotiations with Anthem appear headed for failure.

“We are working hard to resolve these issues, and Anthem has made it very difficult,” Doerr wrote. “They simply will not talk to us or acknowledge the proposals we have put on the table.”

Union Hospital gave notice to Anthem in February that it was terminating their current contract as of July 31 if the two sides failed to reach an agreement. In May, the hospital issued a media release stating it appeared “unlikely” an agreement could be reached.

Tuesday’s letter appears to be the strongest statement yet that the talks, which started more than a year ago, will fail.

Meanwhile, an Anthem spokesman reached Tuesday said the insurance company plans to continue to work toward an agreement.

“While we are frustrated at the lack of progress, we realize that there are still 30 days left under the current contract,” said Tony Felts, an Anthem spokesman in Indianapolis. There is still “ample time for us to reach an agreement that is fair to all sides.”

Felts also said the insurance company recently invited Doerr to join the talks “in hopes of moving the negotiations forward.”

“It’s a matter of availability,” said Union Hospital spokeswoman Lorrie Heber when asked if Doerr would attend the talks. “He’s willing. It just depends on the date and the time.”

Union Hospital Health Group is using a consulting firm based in North Carolina to conduct its negotiations. Anthem regional vice president Eric Schmitz is currently the lead negotiator for the insurance company.

In Tuesday’s letter, which is headed, “Dear Patient,” Doerr writes, “We can assure you that if July 31 comes and goes without a new contract and Union Hospital is forced out of Anthem’s network, we will work diligently to ensure a smooth transition.”

The letter also urges patients to contact Union Hospital with questions about possible “out-of-network” status. It also urges them to contact a top Anthem official to “make your voice heard.”

“You do not have to accept health care that is dictated by Anthem,” the letter states.

Much of the disagreement between Anthem and Union Hospital centers on Anthem’s reimbursement for medical services provided in outpatient clinics under contract with Union Hospital Health Group.

“Maybe this is what health care has come to, with powerful insurance companies like Anthem deciding what care people deserve and what we can provide,” Doerr states in his letter. “We just won’t go along with something that is so obviously bad for you, local physicians, Union Hospital, and the entire community.”

Anthem officials, in a June 24 interview with the Tribune-Star, said they were not trying to control the services Union Hospital offers. Rather, they were offering to reimburse the hospital for services performed at outpatient facilities at rates similar to those other outpatient facilities receive.

Anthem’s latest offer would “impose a multi-million dollar loss over the next three years on Union Hospital,” Doerr states in the June 30 letter.

“There are 30 days left under the current agreement,” Anthem’s Felts repeated Tuesday evening. “I don’t think it advances the talks in any way to issue these sorts of statements that will only serve to scare the public unnecessarily. We remain hopeful and we’ll keep the lines of communication open.”

Arthur Foulkes can be reached at (812) 231-4232 or arthur.foulkes@tribstar.com.

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