Healthcare News & Insights

Best and worst: 2013 National Payor Survey

After surveying 373 hospital and health system executives, ReviveHealth has released its 7th Annual  National Payor Survey results. And the winner and loser are …

154015695When it comes to overall favorability, BlueCross BlueShield (BCBS) tied Cigna for the honors among the seven health insurance plans in this year’s survey. Last year Cigna won and BCBS came in third place.

WellPoint/Anthem won the dubious honor of having the worst favorability rating for the second year in a row.

Background

The survey was done in partnership with Catalyst Healthcare Research  and The Godbey Group.

It targets hospital leaders who negotiate managed care contracts with national health insurance companies. Respondents included CEOs, CFOs and managed care/payor relations executives.

The seven health insurance plans included in the survey were: UnitedHealthcare, Independent BCBS, Cigna, Aetna, Humana, Coventry and WellPoint/Anthem.

Key findings

One major point that this year’s survey revealed is a lack of correlation between payment rates from a payor and a hospital’s perception of that payor.

In other words, just because a payor doesn’t have the best payment rates doesn’t mean health execs think poorly of it. For example, while BCBS plans ranked highest in terms of being the overall best to deal with, they had the lowest ranking in terms of payment rates to hospitals.

The reason for this is trust, noted ReviveHealth CEO Brandon Edwards, in a press release. “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.”

Some other interesting findings from the study include:

  • For the third year in a row, Aetna is raked as having the best rates, followed by Cigna.
  • UnitedHealthcare ranked worst for honesty and candor for the fourth consecutive year. Researchers hypothesize this is due to hospitals ending up being paid significantly less than what they believed they would be paid based on their negotiated contracts.
  • UnitedHealthcare also is seen as the worst on all contract negotiating factors measured in the survey except for payment rates.

Contracting priorities

So what are your peers looking for when it comes to payor contracts in the coming year?

The top five priorities are:

  • increasing their rates with their largest payor (51%)
  • achieving better language protection against denials (42%)
  • increasing their rates with their second and third largest payors (32%)
  • dealing with the threat/opportunity of narrow networks in their markets (31%), and
  • better contracting language with their largest payor (31%).

So what got the distinction of being the lowest priority for healthcare execs?

It would seem that bundled payments for medical homes, ACOs or other population health strategies took that honor with 22%.

To view or download the complete survey results, click here.

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