Hartford Hospital, Anthem Blue Cross & Blue Shield At Standoff [The Hartford Courant, Conn.]

Sept. 21--Hartford Hospital and Bristol Hospital are at a standoff in their negotiations for compensation rates with Anthem Blue Cross and Blue Shield in Connecticut, the state's largest health insurer.

Hartford Hospital has been negotiating with Anthem since February, said James Blazar, the hospital's senior vice president and chief strategy officer.

"I was optimistic going into Friday," Blazar said. But the two sides do not agree on the hospital's suggested increase in reimbursement rates for medical services. The proposed increase not disclosed. A current three-year contract expires Oct. 31.

Hartford Healthcare notified Anthem of its intent to terminate its participating hospital contracts for Hartford Hospital and Windham Community Memorial Hospital with Anthem effective Oct. 31.

"Anthem has proposed increases to both hospitals that would continue to provide them with reimbursement at a margin over their costs," said Anthem spokeswoman Sarah Yeager. "Anthem is seeking an agreement with the hospitals that will allow our members access to quality health care, while trying to manage the cost of health care and rising premiums."

If the insurer were to drop the hospital, it would be taking with it one fifth of the total hospital's total customers, including Medicare and Medicaid patients. In terms of all managed-care patients at Hartford Hospital, half have Anthem as their health insurer, Blazar said.

Hartford Hospital has about 7,000 employees at the main campus, and 11,000 across the Hartford Healthcare system which includes Windham Hospital, MidState Medical Center in Meriden, an office in West Hartford and gastro-intestinal services in Glastonbury.

Anthem also is at an impasse in negotiating rates with Bristol Hospital. Anthem currently plans to terminate its relationship with Bristol Hospital on Nov. 1 after the insurer and hospital failed to reach an agreement, prompting Attorney General Richard Blumenthal to jump into the debate.

"This termination would have a profoundly serious impact on residents of Bristol and its surrounding communities who depend on Bristol Hospital's services," Blumenthal said. "The proposed termination affecting a substantial portion of the hospital's commercial insurance revenues -- could permanently undermine its financial stability."

Yeager, the Anthem spokeswoman, said, "Anthem has been working with Bristol Hospital in good faith for well over a year, but to date Anthem and Bristol Hospital have not reached agreement on the terms of a contract renewal. If we are unable to reach agreement, then effective Nov. 1, Bristol Hospital will no longer be a participating hospital with Anthem. We are currently in discussions with the hospital and have a goal of concluding our negotiations shortly."

On Monday, a private group of doctors that partners with Hartford Hospital wrote a letter to Anthem, critical of what it described as the insurer's contingency plans to shift patients to other hospitals in the area.

"There is no other hospital in the region that is capable of providing the vital infrastructure necessary to deliver the highest quality care that your patients in this community have come to expect," the Connecticut Surgical Group wrote in a letter that appeared as an advertisement on A12 of Today's Courant.

There was no immediate comment this morning from Anthem, or from Hartford Hospital.

Negotiations between hospitals and insurers occasionally cause strife but rarely reach a point where services are halted. For example, last year, Hartford Hospital threatened to leave Aetna's network but the insurer and the hospital came to an agreement in November 2009 for a two-year contract starting Jan. 1, 2010. Details of the that contract were not released.

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