Hospitals And Insurers Lock Horns Over Pricing

The Boston Globe: Insurers Say They Oppose Mass General Brigham’s Expansion
The Massachusetts Association of Health Plans, which counts 15 of the state’s largest insurers except Blue Cross Blue Shield, has come out against Mass General Brigham’s proposed expansion. The organization is another in a line of critics, including competitors and community organizations, who have opposed the $2.3 billion project. Mass General Brigham has proposed opening or growing ambulatory sites in Westborough, Westwood, and Woburn, and expanding Massachusetts General Hospital and Brigham and Women’s Faulkner Hospital in Jamaica Plain. The expansion, MGB says, will help increase capacity at its downtown hospitals and bring lower-cost outpatient care to its patients in the suburbs. (Bartlett, 3/15)

Vermont Public Radio: Vermont's Largest Hospital System And A Massive Insurance Company Are Deadlocked. Thousands Of Patients Are Caught In The Middle
Late last month, almost 2,000 Vermonters got letters in the mail saying the University of Vermont Health Network will soon no longer accept their insurance. They’ll have to go elsewhere for medical care starting April 1. (Krupp, 3/16)

In other news about the health insurance industry —

Modern Healthcare: Lawsuits, Complaints Shine Light On Centene's Challenges
Centene employees and customers' recent complaints against the $32.5 billion insurer highlight the challenges large companies face as they grow through acquisition. During the past month, the insurer has been hit with four proposed class-action lawsuits on behalf of its workers, three of which allege administrative and technology failures led the insurer to shortchange employees on pay. Another suit alleges mismanagement of the company's retirement benefit plans led the portfolios to underperform. (Tepper, 3/15)

Modern Healthcare: SCAN's Medical Group For Homeless Patients Grows Insurer Clients
SCAN Group's medical not-for-profit, specializing in care for the homeless, officially secured its first independent insurer contract, with Healthcare in Action's partnership with Molina Healthcare cementing the company's plan of leveraging local health plans and health systems as customers. Molina Healthcare, which is headquartered in Long Beach, has partnered with Healthcare in Action to provide care for its homeless members and sign the unhoused up for its Medicaid plans. Molina is one of the largest Medicaid carriers in the nation with 4.1 million enrollees, and about half of the 163,000 individuals without homes in California qualify for some form of health insurance, the company says. (Tepper, 3/15)

KHN: How To Avoid Surprise Bills — And The Pitfalls In The New Law
Patients are no longer required to pay for out-of-network care given without their consent when they receive treatment at hospitals covered by their health insurance since a federal law took effect at the start of this year. But the law’s protections against the infuriating, expensive scourge of surprise medical bills may be only as good as a patient’s knowledge — and ability to make sure those protections are enforced. (Weissmann, 3/16)

And in Medicare updates —

Bloomberg: Medicare Watchdog Warns Of $12 Billion In Excess Payments
Medicare Advantage is leading the U.S. government to spend billions more on seniors’ medical care than it should and needs a significant makeover, a nonpartisan watchdog said in a report to lawmakers. The program collected $12 billion in “excess payments” in 2020 over what the U.S. would have paid to cover people who used the private plans under standard Medicare, according to a report by the Medicare Payment Advisory Commission, or MedPAC, released Tuesday. (Tozzi, 3/15)