Mass General president: Size helps Partners set high prices for insurers

A top executive of Partners HealthCare said the Boston-based health system's market power allows it to set higher prices than its competitors — and in return, force higher reimbursement from private insurers, according to a video obtained by GoLocalProv News.

In the video, Peter Slavin, MD, president of Partners' Massachusetts General Hospital in Boston, said, "The payments we get from insurers are higher than the average payments that go to other hospitals and physician groups in this state." He was responding to a question from an emergency resident at Mass General. The resident asked Dr. Slavin how higher reimbursement from private payers to Partners could affect the viability of smaller hospitals with unfavorable payer mixes.

As quoted by GoLocalProv News, part of Dr. Slavin's response was as follows: "One of the reasons Partners was created, but far from the only reason, is that back in the early '90s, the insurance companies were playing MGH and [Boston-based Brigham and Women's Hospital] off one another and basically [saying] to the MGH if you don't accept our lower rates we're going to move our patients to the Brigham and vice versa.

"So we came together as Partners — we do contracting together — and now insurers have to take either both of us, or neither of us, and that has helped level the playing field."

Mass General Hospital and Brigham and Women's Hospital are both under the Partners umbrella, and are among the largest hospitals in New England. Partners is also in the process of buying Care New England, based in Providence, R.I.

In an emailed statement to Becker's Hospital Review, Partners' Vice President of Communications Rich Copp said, "In the video, which is several years old, Dr. Slavin is describing the healthcare environment during the early-to mid-1990s.  However, in today's healthcare environment, Partners and other providers across Massachusetts are keeping healthcare cost growth in check, staying well under Massachusetts' cost growth benchmark. Together, Brigham Health and Care New England can help improve access to care while controlling healthcare costs for patients in Rhode Island. Additionally, it is worth noting that Rhode Island hospital rates have been negotiated with the Office of the Health Insurance Commissioner and can't be changed. The Governor's executive order keeps the growth in insurance premiums below 3.2 percent each year through 2022."

More articles on healthcare finance:
Hedge fund manager predicts CHS will go bankrupt
Washington health system files for bankruptcy, cites issues with revenue cycle vendor
CEO Wayne Smith bets on CHS turnaround with $3M investment

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months