Mark Lutes, a Member of the firm in the Health Care and Life Sciences practice, in the Washington, DC, office, was quoted in an article titled “CareFirst Threatens Hospitals in Cost-Control Move Aimed at Docs.”
Following is an excerpt:
Opening a controversial new front in the health insurance industry’s battle to contain medical spending, CareFirst BlueCross BlueShield is threatening to punish prominent area hospitals if their independent specialists don’t join the insurer’s health plan. According to a letter obtained by the Washington Business Journal, hospitals that currently enjoy the insurer’s “Blue Distinction Center” status, which can generate more business for those hospitals in six high-cost specialties, will be kicked out of the program Aug. 1 unless the specialists sign a contract with CareFirst.
Mark Lutes said the letters are merely a negotiating position. Though providers may find the requests objectionable, they’re free to reject the contract changes, and run the risk of losing patients covered by CareFirst who seek out the Blue Distinction Centers because of their purported higher quality.