Payers, providers seeing more cut contracts: 5 takeaways

Payers and providers are having a harder time landing network contracts, and patients’ wallets are stuck in the middle as they face more out-of-network care, Forbes reported Nov. 16. 

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Here are five takeaways:

1. Healthcare consultant Beth Spoto told Forbes that she chalks the trend up to the growing size of hospital systems and insurers defaulting to hardball negotiating tactics. 

2. The trend hurts patients in regions where single health systems dominate their options. Forbes pointed to recent disputes between UnitedHealthcare and Wellstar, as well as Anthem and Dignity.

3. Physicians are also feeling pressure, as tough negotiations include group physician contracts, healthcare consultant Dave Smith told Forbes

4. Molly Smith, American Hospital Association vice president, said hospitals feel the strain the most when negotiations are headed by payer executives who are detached from the health system’s region.

5. The disputes are especially impacting members who are looking at other health plan options. One patient told Forbes that UnitedHealthcare and Wellstar’s contract conflict is putting cost in limbo because of an outstanding continuity-of-care application. Another patient said the same dispute forced her to cancel appointments with her family’s physicians.

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