Norton and Anthem dispute over, but will relationships with patients mend?
By: Health Insurance
Submitted: 2009-10-29 12:01:03 | Word Count: 1139
Amy De Renzo was angry when she learned a severed contract between Norton Healthcare and health insurer Anthem would keep her from delivering her second baby at Norton Suburban Hospital She’d “had a good experience” when her first son was born there two years before and was planning to go back.
But De Renzo reluctantly switched to Baptist Hospital East — and was won over by the nurses who cared for her and her son Grey, born Oct. 2.
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“I felt like they really cared that this was a very important life that was coming into the world, and that I was a very important patient,” said De Renzo, a Louisville lawyer who says that if she has another child, she’s going back to Baptist. De Renzo’s story illustrates the challenge that both Norton and Anthem have in restoring customer confidence after a 3½ month contract impasse disrupted health care for some 250,000 people in the Louisville area.
She is one of the roughly 40 percent of Norton patients with Anthem coverage who changed to other health-care providers during the stalemate that began July 1 when Norton withdrew from Anthem’s network after the two sides could not reach agreement on reimbursements and other issues.
Norton’s challenge now is to try to win those patients back — just as Anthem may need to shore up relations with disaffected members who had to change doctors or pay extra costs because of the dispute.
“We certainly apologize that people experienced disruption,” Norton CEO Stephen A. Williams said in an interview Friday. “It was an unfortunate circumstance that we regret had to occur.”
Williams said Norton will strive to retain its Anthem patients who stuck with the company “and to earn back those who felt they had to make a move.”
He said the healthcare company, which operates five hospitals and numerous other facilities, will rely on “quality, compassionate clinical care” to retain or win back patients. But it also plans a mailing to patients to make sure they know Norton is back in Anthem’s network and to offer help with lingering questions.But while Norton regrets the inconvenience patients underwent, Williams said it was important to negotiate a new contract with Anthem to put Norton on a “firm financial footing” that allows it to keep providing care to nearly half the area’s residents, including children who come to Kosair Children’s Hospital.Under its old contract, Norton would have received a 5.5 percent raise from Anthem on Oct. 1. But Norton had argued that a new deal was needed because Anthem’s reimbursements were lower than those paid by other insurers.
Neither side has released details of the new contract.
Critical time for Anthem
Many people didn’t have the option of changing insurers during the dispute, especially if they are covered through their employer.
But for Anthem, the challenge may be to retain members for next year — and fall is a critical time for that. It’s when many employers decide on next year’s insurance carrier, and Medicare Advantage members can begin choosing their 2010 health plan Nov. 15.
Al Pepper, 77, is one of those members. He has had an Anthem Medicare Advantage plan for about 10 years.
But on July 1, the day Norton withdrew from Anthem’s network, he said he planned to find another insurer at his first opportunity. He was scheduled for back surgery at Norton Hospital but was concerned Anthem wouldn’t cover it.
“Once this is behind me, I’m not going to do business with Anthem anymore,” he said then.
But after the new contract was announced, Pepper relented.
He said he still planned to shop other insurers’ Medicare plans, but won’t rule out Anthem if he’s sure Norton Hospital’s spine doctors are securely in its network.
“At this point in time I am not going to say no to them, but I am certainly going to listen to” other insurers, Pepper said.
The new contract’s timing worked in Anthem’s favor. The insurer told Norton it wanted an agreement by Oct. 1 so it could set rates for 2010 and inform customers. But the Oct. 18 announcement also came before many local employers made final decisions on next year’s coverage, said Deb Moessner, Anthem’s Kentucky president.
That means those employers no longer will worry that their workers will lack access to Louisville’s largest health-care provider if they renew with AnthemMoessner said Anthem has not lost a substantial number of customers to other insurers because of the dispute.
She declined to give a number, but said the loss has been far less than what Norton has alleged. Norton said in September that employers covering nearly 40,000 people in the region had decided to leave Anthem.
“We are very pleased with the level of retention that we experienced during the time that Norton was out of the network,” Moessner said. “Bottom line is, we received great support from our customers. … We were working on their behalf to ultimately control health-care costs.”
Still, she said, “we understand that our customers have choices when it comes to (their) health insurance carrier. And we don’t take that lightly.”
Moessner said Anthem doesn’t plan ads or member mailings related to the Norton issue. Instead, Anthem representatives and the insurance brokers it uses to sell health plans will “get the message out that we’ve resolved the issue, and have … a long-term, fair agreement in place.”
A key part of that message is that the new contract doesn’t allow either party to withdraw without cause after giving six months’ notice, as the old contract did. That should give employers confidence that this year’s disruption won’t be repeated, Moessner said.
Patient retention
Norton’s Louisville competitors — Baptist Hospital East, Jewish Hospital & St. Mary’s HealthCare, and UofL Health Care — all reported gaining substantial numbers of Anthem patients during the contract dispute.
For example, the organization of physicians employed by Jewish & St. Mary’s gained 4,200 Anthem patients from July to mid-October — 72 percent more than the number gained in the same period last year, company spokesman Jeff Polson said. And UofL Health Care treated about 30 percent more patients in August and September than in the same period last year, spokesman David McArthur said.
