Highmark

Highmark helps providers, patients know costs up front

Anne Zieger — Thu, 04 Dec 2008 09:19:42 -0500

Health plan Highmark is giving its providers a new way to reduce bad debt that can result when patients aren't prepared for the large costs they may incur under high-deductible plans. Under its new program, doctors and hospitals can get real-time quotes of how much a service will cost members, helping them to be sure that patients can afford costs, or even allowing them to collect an exact amount up front.

This allows both the provider and the patient to be on the same page, especially when the patient has a plan with a high deductible or co-insurance. Right now, the service is just being rolled out to 250 providers across Pennsylvania. In April 2009, all Highmark providers across the state will have access to the system.

To learn more about the system:
- read this Healthcare Finance News piece

Lawmakers largely oppose PA Blues merger

Anne Zieger — Wed, 19 Nov 2008 10:13:33 -0500

Pennsylvania commissioner Joel Ario gets to make the final decision on the proposed merger between Independence Blue Cross and Highmark Inc.--but the state's lawmakers are not shying away from giving their honest opinions about it. As Ario thinks over his decision, he's getting hammered over the issues involved.

The overwhelming consensus among state legislators is that he should reject the merger outright. Many are concerned that creating what will be the largest insurer in the state will eliminate competition and force doctors and hospitals to accept low fees because of an inability to negotiate.

Ario's decision cannot come until January 27 at the earliest, giving legislators--and the two Blue plans, of course--a chance to keep chiming in with their opinions before he releases his decision.

To learn more about the objections to the proposed merger:
- read this Philadelphia Inquirer piece

Questions raised on PA Blues merger

Anne Zieger — Fri, 12 Sep 2008 10:58:31 -0400

The Pennsylvania Insurance Department has released two reports analyzing the potential impact of the proposed merger between Highmark and Independence Blue Cross, which have raised some concerns about the merger's effect on long-term competition, as well as whether the merger could lower provider reimbursement. The two not-for-profits, which announced their plans to merge in March 2007, would create the third-largest Blue plan in the nation if they combine.

According to one report, by economic adviser LECG, the merger wouldn't prevent competition in the state, but could tighten up Highmark's dominant position in the west part of the state and Independence's grip on southeast Pennsylvania. Meanwhile the Blackstone Group, a financial adviser, concluded that the merger wouldn't harm the financial health of either plan, and that policyholders would still likely have access to the same providers, health plan choice and customer service--but that they weren't sure whether the merger would lead to lower payments to providers. (Sort of a key question to waffle on, isn't it?)

To learn more about the analysis:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
Highmark pays $10M to settle physician class action
Consumers, legislators challenge PA Blues merger
AMA cites antitrust activity among insurers

SPOTLIGHT: PA insurers face merger scrutiny

Anne Zieger — Fri, 11 Jul 2008 01:41:39 -0400

For many months now, Pennsylvania health plans Independence Blue Cross and Highmark have been waiting for the chance to defend their planned merger--and now, at long last, they've gotten their hearing. However, they're not getting much love from observers. The merger, which would create the state's largest health insurer, has many critics. Among the toughest are the state's doctors, who argue that the merged entity would use its cloud to batter down doctors and hospitals on fees. Doctors voiced their concerns at a recent hearing on the merger run by the state's insurance commissioner. Article