As UnitedHealth negotiations intensify, Envision targets surprise billing with new marketing blitz

Medical bill healthcare cost price patient spending
Envision's new marketing campaign looks to shift the blame of surprise billing to insurers. (Getty/everydayplus)

An emergency department staffing firm frequently embroiled in surprise billing allegations unveiled a new marketing campaign Wednesday positioning itself as a defender against such practices.

Envision Healthcare, which has absorbed criticism from lawmakers, insurers and researchers for its reliance on surprise bills, launched a marketing blitz claiming that it is working to “resolve the challenges with care coverage” and deflecting the blame of surprise bills to insurers.

In a video, the company specifically sites high deductible health plans, narrow networks and care denials as the reason for what it calls “surprise coverage.”

Free Daily Newsletter

Like this story? Subscribe to FierceHealthcare!

The healthcare sector remains in flux as policy, regulation, technology and trends shape the market. FierceHealthcare subscribers rely on our suite of newsletters as their must-read source for the latest news, analysis and data impacting their world. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.

“As one of America’s largest physician groups, Envision clinicians share the frustration our patients experience due to surprise coverage,” CEO Christopher A. Holden said in a statement. “Patients should focus on getting better, not worrying about unexpected bills resulting from surprise coverage and gaps in health insurance.”

RELATED: Investment firm KKR to acquire Envision Healthcare in $9.9B deal 

It's a “ballsy attempt at a market campaign” from a company that has “adopted out-of-network billing as an explicit strategy,” says Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy.

“It’s pretty funny to all of a sudden see them position themselves as champions of patients receiving surprise bills as it certainly appears they are one of the main culprits of surprise bills,” Adler told FierceHealthcare.

The evidence against Envision, which owns the ED staffing company EmCare, has been damning. A 2017 study (PDF)  by a group of Yale researchers found that when a hospital contracts with EmCare, its out-of-network billing rates increased between 81 and 90 percentage points. Overall, hospitals that contract with EmCare have out of network billing rate of 62%.

Last year, Sen. Claire McCaskill, D-Mo., accused EmCare of “gaming the system” in order to increase profits. The company has also been the target of several legal case, including a class action lawsuit filed in Florida earlier this year.

But public sentiment may be on their side. A recent survey by NORC at the University of Chicago found 86% of Americans blamed insurers for surprise bills. 

It’s no coincidence that Envision’s campaign comes in the midst of negotiations with UnitedHealthcare, which has threatened to cut Envision’s ED providers out of its network. Last week, UnitedHealthcare sent a letter (PDF) to more than 950 hospitals that use Envision’s services warning them that they may “experience a decrease in patient satisfaction driven from higher out of pocket costs and patient confusion.”

RELATED:  UnitedHealthcare to cut ties with Envision, citing ‘highly questionable’ billing

The dispute dates back to April when UnitedHealthcare first threatened to cut ties with the company, citing “highly questionable” billing practices. Negotiations have stalled because Envision requests a rate 600% more than what Medicare allows, according to the insurer.

UnitedHealthcare spokesperson Stephen Shivinsky said Envision’s campaign appears to be in response to UnitedHealthcare’s letter and its own website blaming Envision for the “skyrocketing cost of ER services.”

“Our goal is that we work to find a solution that gets them to renew their position in-network at rates that are affordable and predictable,” Shivinsky told FierceHealthcare.

Envision’s newfound concern about surprise billing is likely a way to sway public opinion as the topic continues to generate additional public scrutiny. Congress is also considering several bills with bipartisan support that would limit surprise billing.

While Envision may have emerged a primary target for surprise billing, Adler points out that the issues run much deeper.

“This is also just the incentives we set up as a country,” Adler said. “It’s not like you can just hope people are going to be good and not try and make money. It’s not a reasonable policy position.”

Suggested Articles

Humana filed suit Friday against more than a dozen generic drugmakers alleging the companies engaged in price fixing.

Ochsner Health System is partnering with Color to launch a population health pilot program to integrate genetic information into preventive care.

Medicare Advantage open enrollment kicked off last week, and insurers are taking new approaches to marketing a slate of supplemental benefit options.