SOUTHERN CALIFORNIA: Hospitals, Insurers Have Tenuous Relationship
Southern California hospitals and health plans are often at odds, according to a Healthcare Association of Southern California survey ranking the 13 largest health plans in the area. The survey queried 76 hospitals about their satisfaction with insurers that they contract with and found that only 37% of Southern California hospitals rated the overall performance of health plans as "good" or "excellent," and only 29% of physician groups said the same. Of the 13 plans included in the survey, 50% rated only Aetna U.S. Healthcare, PacifiCare, Blue Shield of California and CIGNA as "good" or "excellent" (HASC release, 3/10).
The Blame Game
The Riverside Press-Enterprise reports that the hospitals complained that insurers are slow to approve care and pay bills, and are often make billing mistakes. Insurers argue, however, that hospitals often fail to quickly notify the companies that it has treated a member. HASC released the survey results for the first time this year, in part to spur health plans to address the concerns detailed by the hospitals. Health Net spokesperson Ron Yukelson said that despite the plan's high rating -- 44% of hospitals rated it "good" or "excellent" -- the survey is not an indicator of the care that members receive. But HASC Executive Vice President Jim Lott said any squabbling between plans and providers is likely to affect patient care (Spielvogel, 3/10).