Pros And Cons To Blue Cross Dominance
By Patrick McCreless, The Anniston Star, Ala. | |
McClatchy-Tribune Information Services |
"Whenever you have a situation where you have a single insurer, they certainly have the market power and can drive down contracts with providers," said
RMC officials have said
Attempts to reach an RMC representative for comment Wednesday were unsuccessful.
"This is pretty standard in negotiations between insurers and providers," Becker said regarding RMC's dispute with
The lack of competitive insurance markets across the country has much to do with the payment battles.
According to a 2013 study by the
The study concludes that such dominant market power increases the risk of anticompetitive behavior by health insurers, which can hurt patients and physicians.
"Though we are a stable and dependable source of revenue for hospitals, physicians and other providers, we have to balance the payment wishes of providers against the increases in premiums to our customers that higher medical costs bring," Mackin said.
Becker said
"By being the only game in town, they are able to bring tremendous leverage on providers," Becker said. "But if they bring lower premiums, we should like that as consumers."
"If there's a single insurer, they are no longer the price takers, they're the price givers," Miller said of insurance payments.
However, that power is less in markets where hospitals have consolidated, Miller said.
"In the last two to three years, a lot of hospitals have been buying up physician practices to bring in more revenue, but also to offset more bargaining power so they can get better prices," Miller said. "Many hospitals are in a stronger position than most insurers would tell you ... in general, hospitals have been not suffering greatly."
In recent years RMC has bought
"If they're going it alone, it makes it more difficult," Becker said of RMC's attempts to obtain higher payments. "Doing it alone definitely puts them in a tough spot."
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