Indianapolis-based Anthem Blue Cross and Blue Shield is making hospitals an offer that is nearly unheard of, according to an Indianapolis Business Journal report.
Anthem is asking hospitals to join its "reference lab network" that offers blood testing, imaging and lab procedures at steeply discounted prices.
The health insurer has already gotten 63 hospitals on board to reduce their prices for blood and tissue testing by between 50 and 80 percent as part of its reference lab network — 50 to 80 percent off the discounted price the health insurer had previously negotiated with the hospitals, according to the report.
Anthem will update its website in mid-May to reflect the new prices offered by labs participating in its reference lab network, and these prices will also appear in Castlight Health and other price transparency tools later in the year.
"The hospitals and the other higher-cost providers, certainly can stay with the contracted rates we have with them," David Lee, MD, Anthem's vice president of provider engagement and contracting told the Indianapolis Business Journal. "But they are increasingly likely to see patients go elsewhere if they stay with their contracted rates. That was basically the discussion we had with them."
According to Larry Heydon, president and CEO of Franklin, Ind.-based Johnson Memorial Health, baseline procedures — such as imaging and lab procedures — are hurting hospitals because niche providers are increasingly providing those services at much lower costs.
In June, data from the United Automobile Workers health plans revealed some healthcare providers — namely hospital systems — were charging lab and imaging procedures six- to nine-times higher than prices charged by independent providers.
Anthem has had a reference lab network in Indiana since 2011, as well as in Kentucky and Ohio, but started adding more hospital systems to its networks about a year ago due to demand from employers, according to the report. In March, Indianapolis-based Indiana University Health became the first hospital system with statewide reach to join Anthem's reference lab network.