by Nashville Health Care Council | May 07, 2013

WellPoint/Anthem Ranks Worst Health Plan Second Straight Year

 

  • 2013 ReviveHealth National Payor Survey Reveals Trust Factor as Important as Rates
  • Cigna, Independent BlueCross BlueShield Plans Tie for Best Overall Favorability
  • UnitedHealthcare Continues Perennial Poor Showing
  • Wellness Programs Cited Most Often as Hospital Strategy

Nashville, Tenn. – With favorability ratings on par with Congress, health insurer WellPoint for the second year in a row ranked worst in overall favorability in a national opinion survey of 373 hospital and health system executives. Conversely, the health plan’s not-for-profit Blue Cross Blue Shield brethren ranked best in overall favorability, tied with Cigna, which made the top of the favorability list for the second straight year, according to results released today from the 7th Annual ReviveHealth National Payor Survey.

Hospital executives surveyed gave WellPoint, which runs Anthem Blue Cross in California and health plans in 13 other states, an overall favorability rating of 16 percent compared to independent Blue Cross Blue Shield plans’ rating of 49 percent, tied with Cigna. Independent BlueCross BlueShield plans, however, ranked well ahead of Cigna (30 percent compared to 19 percent) in terms of overall best to deal with, despite having the lowest ranking in payment rates to hospitals, the survey found. For several years in a row, the survey revealed a complete lack of correlation between payment rates from any payor and a hospital’s perception of that payor.

For the third consecutive year, UnitedHealthcare ranked worst to deal with (30 percent versus the next worst WellPoint/Anthem at 14 percent), holding firm as the health plan with the most consistently poor reputation among hospitals and the slowest to pay. Hospitals year in and year out cite UnitedHealthcare’s low rates, slow payments, bureaucracy, and honesty as reasons for their poor rankings.

“The trust factor is huge when it comes to hospitals and health plans being able to play nice in the new world order of risk-sharing and improved health outcomes,” said ReviveHealth CEO Brandon Edwards. “Even though WellPoint now has a CEO with a strong provider background, he’s got to turn an aircraft carrier, and that takes time. Their major imperative has to be improving their reputation and rebuilding trust with providers.”

The survey, conducted in partnership with Catalyst Healthcare Research (CHR) and The Godbey Group, is the only one of its kind in the country, targeting hospital leaders who negotiate managed care contracts with national health insurance companies. Respondents include CEOs, CFOs, and managed care/payor relations executives who negotiate on behalf of about one-third of all hospitals in the U.S. The goal of the study is to provide a national perspective of hospital leaders’ opinions of large health plans. A total of 373 responses were collected during the period of February 5 – March 31, 2013. The margin of error is +/-4.8%.

Complete survey results are available at http://thinkrevivehealth.com/press/#thought-leadership.

Other key findings include:

  • Aetna is ranked as having the best rates for the third straight year followed closely by Cigna, while independent BCBS plans have the worst rates three years running.
  • Honesty and “candor” represent the biggest challenge for United. The company ranked worst for honesty and candor for the fourth consecutive year. This is most likely tied to hospital rankings of the low yield on United contracts, meaning hospitals end up being paid significantly less than what they believed they would be paid based on their negotiated contract. United also ranks at the bottom when it comes to claims denied and timely payment.
  • The gap between rates for the largest payor, and rates for the second largest and below are wider than ever. This “payor cost shift” drives up profitability for the biggest plans at the expense of the smaller-market-share plans, proven by the fact that more than a third of hospitals said they would be bankrupt if all private payor rates were the same as their largest payors’ rates.

Meanwhile, when it comes to other strategies being pursued by hospitals and health systems, hospitals are taking the lead on wellness programs for their own employees, citing wellness as the most widely adopted success strategy, above ACOs, clinical integration, and direct contracting with employers:

  • Two-thirds (67 percent) say they have a wellness program for their own employees in the works. That’s up sharply from 56 percent in 2012.
  • Clinical Integration is the second most popular strategy, with 41 percent saying this is underway in their organization, down slightly from 46 percent in 2012.
  • More than half said they have an ACO strategy in place (only 27 percent reported actual implementation), up sharply from 36 percent in 2012.
  • About one in three (28 percent) said they are involved in direct contracting with employers compared to 20 percent the previous year.
  • With tiered and narrow networks suddenly commonplace, 29 percent said they have a strategy in place for dealing with the change while another 23 percent said they are planning and preparing for them.

View or download the complete survey results at http://thinkrevivehealth.com/press/#thought-leadership. For questions or further interpretation of this year’s survey results, please contact learnmore@thinkrevivehealth.com.

About ReviveHealth
ReviveHealth is the leading strategic communication firm specializing in Health Services, Health Technology, and Healthy Living. Since its inception, the firm has consistently received industry recognition from PRWeek, The Holmes Report, and O’Dwyer’s for creating strong agency culture, strategic excellence, and client results. Named PRWeek’s 2013 Boutique Agency of the Year, ReviveHealth ranks among the nation’s Top 15 firms for health care strategic communication. The firm’s clients include physician organizations, health care industry associations, health technology companies, wellness and population health companies, major hospitals‚Ä®and health systems, and academic medical centers. ReviveHealth has offices in Nashville, Tennessee, and Santa Barbara, California, and can be found on the web atthinkrevivehealth.com.