Insurer details its unequal payments

[HughMoran]

Source: Boston Globe

Harvard Pilgrim lists hospital, doctor fees; State to open hearing on health care costs
By Liz Kowalczyk
Globe Staff / March 16, 2010

Newly released documents from a major insurer detail how certain hospitals and doctors are paid dramatically more than others for the same types of services, sometimes as much as three times higher.

The vast inequalities emerged in documents filed by Harvard Pilgrim Health Care Inc., the second largest health insurer in Massachusetts, before the start today of state hearings investigating why health care costs are rising so rapidly. Written testimony from Harvard Pilgrim discloses which of the hospitals and physician groups in its network are the best paid and which are paid the worst.

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Harvard Pilgrim’s testimony mirrors the results of a yearlong investigation by Attorney General Martha Coakley’s office, which found that the highest pay goes to the providers with the most clout and not as a reward to those hospitals and medical practices that provide the highest-quality care. The attorney general’s report looked at payment rates from all large insurers. Unlike Harvard Pilgrim’s testimony, Coakley’s preliminary report did not identify providers by name.

A 2008 Globe Spotlight Team series focused on the Boston market found that a small number of hospitals such as Mass. General and the Brigham typically are paid 15 percent to 60 percent more for essentially the same work as other hospitals, even though the quality is not superior. It said the fees paid the Partners hospitals were helping to drive up health costs in Eastern Massachusetts, something critics have called the “Partners effect’’ but that Partners disputes.

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Read more: http://www.boston.com/news/health/articles/2010/03/16/insurer_details_its_unequal_payments/

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It's not just the insurance companies jacking up our healthcare costs; as this article shows, hospitals and doctors are being paid excessive amounts of money based on clout and NOT based on better outcomes for patients.