Ambulatory providers name their most and least favorite payers: 9 survey findings

Medicare beats out all private insurers in a recent peer60 report of the best and worst of the payer market.

peer60 asked 800 ambulatory care leaders who oversee payer relationships to name their favorite and least favorite payers. Criteria like the number of contracts, market share, reimbursement speeds and staff time, among others, were used to generate results.

Payers in the survey include Medicare, Medicaid, Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna, Anthem, Humana, Tricare and Coventry.

Here are nine major findings from the survey:

1. Most favorite payers overall. Ambulatory providers favored Medicare over all other private payers in the survey. BCBS was named providers' second favorite. These results are based on the payers with the largest margin between favorite and least favorite responses.

That is, while 22 percent of providers surveyed preferred BCBS and 16 percent favored Medicare, 11 percent listed BCBS as their least favorite compared to 7 percent who said the same for Medicare.

UHC made the top three, with 9 percent of providers marking it their favorite.

2. Least favorite payers. Twenty percent of providers voted UHC as their least favorite payer. According to the survey, UHC is almost twice as difficult for providers to work with as the second least favorite payer, BCBS.

BCBS received 11 percent of least favorite payer votes, followed by Humana, which 10 percent of respondents deemed most unfavorable.

3. Comparing most and least favorite payers. When percentages of leaders' most and least favorite payers are compared, only Medicare, BCBS, Tricare and Anthem obtain positive results, with Medicare and BCBS taking the widest margin due to their timely reimbursements and fewer denials.

4. Payers with the most contracts. The top 10 payers control 60 percent of contract volume. UHC and BCBS both hold 9 percent of payer contracts among the payers included in the survey. Medicare and Aetna follow, each holding 8 percent of contracts, with Cigna and Medicaid at 7 percent each.

5. Payers with the fewest ambulatory contracts. Coventry holds the least amount of ambulatory contracts at 2 percent. Tricare and Humana each hold 3 percent of all contracts among surveyed payers.

6. Top and bottom of the market. Ambulatory leaders chose BCBS as the leader of the insurance market, followed by Medicare. UHC, while holding the most contracts, is ranked toward the bottom of the market.

7. Top qualities of payers in providers' words. Fifty percent of providers denote faster reimbursements as the top reason they prefer one payer to another. Another 48 percent said they prefer payers who request less staff time and 38 percent prefer payers who deny the least amount of claims.

8. Payers with the best qualities. Medicare takes the cake for having the fastest reimbursements, placing the lowest demand on staff's time and denying the fewest claims. It was also lauded in the survey for ease of negotiation, best pre-certification and the least amount of paperwork. Leaders said Tricare has the best customer service.

9. Providers' top annoyances with payers. Providers said the most irksome insurer behaviors are requiring more of their staff's time (62 percent) , denying claims (52 percent) and poor customer service (46 percent). 

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After losing big insurers, AHIP undergoes first overhaul in 13 years

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