Managed Care

Back to the Negotiating Table

Tufts Medical Center, NEQCA and BCBSMA released a joint statement earlier this week stating their commitment to getting this situation resolved. Here is that statement:

I am encouraged that both parties are back at the negotiating table. However, I also want to be clear that the physicians at Tufts Medical Center and NEQCA still need a fair deal from BCBSMA. There are huge disparities between what NEQCA/Tufts Medical Center doctors are paid and what physicians from comparable organizations are paid. That fact is not up for debate. This contract dispute is about fairness and reaching an agreement that puts Tufts Medical Center and these community physicians in a position to survive in this hostile financial environment.

Stephen Syre had an excellent piece in the Boston Globe a couple of days ago. It was titled “Something has to give in Blue Cross, Tufts dispute.” (November 18, 2011) Here’s a paragraph from his story that sums up the situation with amazing clarity:

“The details of the dispute would make your head hurt. But an important element of the medical center’s position is all about basic fairness. The argument goes like this: Tufts Medical is paid less than some other Boston hospitals by commercial insurers that cover private patients. But about a quarter of patients Tufts treats are covered by Medicaid, and the government’s reimbursements don’t come close to covering the actual cost. Something has to give.” (Boston Globe, November 18, 2011)

As Syre pointed out in his article,”Those Harvard-affiliated hospitals also treat many fewer Medicaid patients – as a percentage of a hospital’s total – than Tufts.” Those Medicaid patients place an additional financial strain on the hospital. And Tufts Medical Center is doing more than its fair share. Add this to the poor reimbursement levels from private insurers like BCBSMA and you’ve got a bleak financial outlook. All Tufts Medical Center and NEQCA physicians want is a fair and equitable arrangement. That’s not too much to ask.

Finally, I hope BCBS members in Eastern Massachusetts understand that this dispute does not necessarily mean that they have to change their physician. Don’t buy into the rhetoric. Given the choice, I would change insurance companies before I changed my physician. That is an option worth exploring! On the website, NEQCA and Tufts Medical Center have supplied information about health plans you can join that will allow you to keep your physician.

My call to action: Although I am encouraged that all parties are talking once again, it is still important for you to let BCBSMA know that you support Tufts Medical Center and demand that they are given a fair deal. Like all of you, I want this situation resolved as soon as possible. I’d like to celebrate Thanksgiving with my family knowing that Tufts Medical Center and BCBSMA have reached an agreement!

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