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.”
“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.”
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.
Worth having a read of their response to my research, where they tacitly admit to going out-of-network in exchange for requiring less comp from hospitals. See section 4.3. Kudos to their brutal honesty https://t.co/xG16NYHnb4. pic.twitter.com/BflPMM34UF— Zack Cooper (@zackcooperYale) October 3, 2018
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.”
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.”