Hospitals, Blue Cross make a deal

Contract standoff with Stanford hospitals ends with a three-year agreement

A two-month contract standoff between insurance giant Anthem Blue Cross and Stanford and Lucile Packard hospitals that left subscribers in limbo regarding their coverage has been resolved.

The hospitals had announced on Sept. 1 the contract with Blue Cross had expired and was terminated, putting thousands of patients in a position of potentially paying more for out-of-pocket costs after the hospitals became non-contracted entities.

But the new three-year agreement will be effective back to Sept. 1, the hospitals announced Tuesday (Nov. 2), so patients will not lose any of their benefits for services rendered during the non-contract period.

"Stanford Hospital, Lucile Packard Children's Hospital, the faculty physicians at both hospitals, and the Menlo Clinic are once again in-network providers for all patients insured by Anthem Blue Cross," the hospitals announced.

Details of the agreement were not immediately disclosed. But the sides agreed on reimbursement rates and contract language "relevant to today's health care environment," the hospitals said in prepared statement.

"We're happy to have these new agreements in place," said Gary M. May, vice president of payer relations and pricing for the hospitals.

"Both Anthem Blue Cross and the hospitals have worked diligently on these issues and everyone is pleased that our patients and families will continue to have full access to our world-class care."

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Posted by about time
a resident of Adobe-Meadow
on Nov 3, 2011 at 9:32 am

Shame on these mega corporations for holding Americans hostage over their contract squabble. The health of American citizens should be more important than corporate profits.

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Posted by Concerned Retiree
a resident of Midtown
on Nov 3, 2011 at 10:33 am

The cost of that multi-million dollar operation to separate the co-joined twins has to be paid somehow. Not nice to say, but it has to be said. Costs for this will appear on the bills of regular patients and their health care insurance.

I, for one, will choose another non-teaching hospital for my needs. Possibly, I will get more bang for my medical buck.

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Posted by musical
a resident of Palo Verde
on Nov 3, 2011 at 12:20 pm

Maybe the retail value of those twins is multi-million, but I'm sure the true cost was much less. They can chalk it up as a training exercise or bury it in the morale or advertising budget. Don't know whether all the personnel were donating their time or just drawing salary. If your grandkids needed an operation like this, I suspect Lucile Packard would be your first choice.

If healthcare were really that profitable, there'd be more of it. If the profits are limited, there will be less healthcare.

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Posted by Scot
a resident of Los Altos Hills
on Nov 3, 2011 at 1:27 pm

None of what follows is concerning the twins, which may hijack this overall discussion - the main subject of the article is mine and that is that this is yet another example of why we have the "world's best health-care system," NOT! Stanford wanted to up their fees by 38% or so I hear from the other trench. No matter, unconstrained, unaccountable suppliers tend to do that sort of thing.

This is what you can expect when nobody in the food chain has the need/desire to be the low-cost provider of quality care. They don't even measure themselves that way. The human life is infinitely valuable so charge that way, the sky's the only limit. Gold-plate on: CEO salaries, Doc salaries, pharm/med supply companies ...and don't forget the CEOs at the insurance companies.

I finally made it on to near-single payer land, Medicare. Soldier on youngsters and fight all changes to your best system in the world.

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Posted by Barron Park
a resident of Barron Park
on Nov 3, 2011 at 2:58 pm

Does someone expect that health insurance providers should not be concerned about profits?? If they weren't, they would quickly be out of business, replaced by others who are more avaricious.

If you want to build the movement for single payer or the like, go for it. Why wait: get together with others and start your own non-profit insurance collective. But to criticize the companies that fill the need in the meantime seems odd.

Note that Anthem's net profits of ~5% are average within the insurance industry, and the insurance industry itself is well outside the group of most profitable industries (many of which call the Bay Area their home)
Web Link

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Posted by Nick
a resident of Midtown
on Nov 3, 2011 at 6:07 pm

"Net profit" is after their admin costs. Sloppy dodgers? The number to check is that one. Medicare's I believe is under 5%. I have only a vague recollection that Anthem's is 28%. Anyone have current accurate figures?

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Posted by Pro-Choice Insurance
a resident of Meadow Park
on Nov 4, 2011 at 6:02 am

Scot:Keep following the bouncing ball.

If Stanford ( or other hospitals, or doctors, nurses and therapists) can't make enough to cover excellent care...and we are "universal health care" and the govt,( the ONLY player in the game) cuts funding ( like they are doing with Medicare and Medicaid)..what happens to the health care we get? There are no options left to choose from. We take what we get.

If government has the power to "provide", it also "takes away". Again, I refer you to Medicare, cut 500 BILLION per year last year just when the rolls are swelling from baby boomers. So, this is a much bigger "per person" cut than just 500 Billion.

Give me ANY DAY the ability to choose my insurance program over a one size, no choice "govt" insurance. If I don't like Anthem ( and I don't) because my options are limited ( because they are..which is why they cost less), even if the rates are lower ( which they are), then I want to keep my choice to pay more for better insurance if I wish.

Taking away our choices is not the way to improved health care.

The false notion in your assertion is that somehow government (other people's money) will provide the money for the best of everything at any time all the time.

It doesn't. Start educating yourself on what medicine looks like in Canada, England, France..or go all the way to Cuba, China and Venezuela to see what great care you end up with with "universal" health care.

You choose your health insurance and pay for what you choose, I choose mine.

Best is to keep each of us free to choose the level of medical care we wish to insure against, then let us buy it, instead of the constantly soaring price of insurance as more and more mandated coverages are included ( which raises the price of the insurance from VW bug level to Jaguar level as our insurances are forced to look more and more lik e Jaguars)

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Posted by Neal
a resident of Community Center
on Nov 4, 2011 at 6:55 am

Does anyone know if Anthem/Blue Cross has settled with the Palo Alto Medical Foundatiion?

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