Lembo urges Anthem, Hartford Hospital to put patients first

State Healthcare Advocate Kevin Lembo is urging Hartford Hospital and Anthem Blue Cross and Blue Shield to put its patients first in their contract dispute and “end this game of corporate ‘chicken.'”

If the two sides do not reach an agreement, Hartford and Windham hospitals, which have the same parent company, could leave Anthem’s network by Nov. 1. The dispute has gone public, with letters sent to patients and ads printed in The Hartford Courant.

Kevin Lembo

Kevin Lembo

In a letter to the heads of both companies, Lembo asked them to consider the impact of their actions on Connecticut consumers.

“I am sorry to report that the view from outside the walls of your respective institutions is that you are forgetting to put patients and their families first,” Lembo wrote. “As you return to the negotiating table, I ask that you end this game of corporate ‘chicken,’ that has caused such fear and uncertainty, and make patients your first priority. They cannot be a forgotten party in this dispute because they have the most to lose, and without them your companies would cease to exist.”

Patients are required to be notified if it appears there will not be an agreement between their insurer and health care provider, but Lembo said in an interview Thursday that more care needs to be given to the language in the notifications.

“It feels to me like it’s being also used as a bit of a tool in all of this to rile folks up,” he said.

Lembo also is the Democratic candidate for state comptroller.

Hartford Hospital has said Anthem pays less than other insurers, while Anthem has said it pays Harford and Windham hospitals comparable rates to what it pays other hospitals.

If the hospitals leave Anthem’s network, patients receiving non-emergency care could be charged out-of-network rates. Patients receiving ongoing care, such as cancer treatment, could still receive care at the hospitals without facing out-of-network rates.

Hartford Hospital Chief Medical Officer Rocco Orlando said that, aside from pointing out that Anthem is not compensating it fairly, the hospital has been “doing our best to not ratchet up the level of rhetoric.”

“First and foremost, we believe that everything we’re doing and all the actions that we’re taking are, we believe, entirely in the interests of our patients and our community,” Orlando said.

He also drew a contrast between the non-profit hospitals, which he said reinvest the money not used for operating costs into the health of the community, and Anthem, whose profits go to shareholders.

“We really believe we are upholding our fiduciary responsibility to meet the community’s needs and to meet the needs of our patients,” he said. “We’re obviously saddened that the conflict is causing patients to be unsettled.”

Anthem spokeswoman Sarah Yeager said the company is negotiating as it has in the past.

“We approach our contract negotiations with the same high level of fairness and integrity that has been the hallmark of our company for over 70 years,” she said. “There has been no change in our approach to our negotiations with Hartford and Windham hospitals.”

Yeager said the company has made multiple offers that would increase the hospitals’ reimbursement rates and allow them to earn “a significant margin” and invest in programs and services to improve patient safety and quality. The hospitals did not accept them and are instead seeking increases that Yeager said far exceed the rate of inflation.

“We know that our members rely on us to balance both access and costs–and that is exactly what we are focused on in this negotiation,” she said. “We are working hard to reach an agreement with the hospitals but the levels of increases they have requested cannot be supported by Anthem employers and members who ultimately pay for these services.”

Public relations fights have accompanied several negotiations between hospitals and insurers in the past two years.

Last year, Hartford Hospital and its affiliates, Windham Hospital and MidState Medical Center in Meriden, gave notice to Aetna – and members – that it would terminate its contracts with the insurer before ultimately reaching an agreement.

Anthem sent letters to members last year notifying them that Middlesex Hospital would no longer be part of its network after the two sides reached a stalemate in negotiations. They ultimately reached an agreement that avoided any network changes.

Bristol Hospital stopped accepting United Healthcare briefly last year after the two sides failed to reach an agreement. They reached a resolution the following month.

Bristol Hospital and Anthem also clashed for nearly 15 months before reaching a contract agreement last month.

Lembo said he has tried not to get involved in contract disputes in the past to avoid appearing to take sides.

“This one just feels like it’s either stuck or not moving, and that the parties, based on their public representations, seem to have forgotten who’s at the center of all this,” he said.