High stakes in health battle - Boston Globe
09.01.09
THE KNOCKDOWN fight between Tufts Medical Center and Blue Cross Blue Shield of Massachusetts over the reimbursement rate for doctors at the hospital is Exhibit B of the dysfunction of the state's health insurance system. Exhibit A, of course, is the much better rate that Partners HealthCare muscled Blue Cross into granting to its teaching hospitals, Mass. General and Brigham and Women's, in 2000. Two sides of the same coin, these deals cry out for reform.
Doctors who meet quality standards while handling complex cases at academic centers should get uniform reimbursement - not just from private insurers but from Medicaid and Medicare as well. Reformed rates should also better reward primary care.
But comprehensive changes will have to await action by a payment reform commission that the Legislature called for last year. Lamentably, that panel has yet to meet. In the meantime, Tufts said Monday that talks with Blue Cross, the state's largest insurer, had reached a stalemate. Starting Feb. 1, Tufts doctors will no longer take part in the Blue Cross HMO plan.
Source: Boston Globe, United States