CMS president responds to news about 2015 health insurance rates

Wednesday, September 24, 2014 01:37 PM
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Aspen Public Radio contacted the Colorado Medical Society in regards to the finalized 2015 health insurance rates. The reporter referenced a Sept. 23 article in the Denver Business Journal, “Insurance chief: Health insurers are largely responsible for slow cost growth in Colorado,” in which Insurance Commissioner Marguerite Salazar says that insurance carriers negotiated lower reimbursement rates for medical providers, and that’s a major reason for insurance rates going up more slowly in 2015 than in previous years.

CMS President Tamaan Osbourne-Roberts responded to the reporter’s questions with the following statement:

“Commissioner Salazar’s news that insurance premium increases will rise at a slower rate in the coming year is certainly welcome; it is also good news (inferred from decreased premiums) that more of Colorado’s health care system has become better integrated and coordinated. The more physicians, hospitals, and other caregivers are coordinating with each other, the more costs will fall due to less redundant, higher quality care.

“However, we know from long experience that simply cutting reimbursements without regard to value has the potential to cause havoc in the delivery system. Inevitably, the volume of services increases to offset such losses; additionally, good care is priced out of the marketplace, leaving behind large gaps in services, longer wait times, increased overuse of the emergency room as a high-cost primary care alternative, and care delays that convert simple problems to acute emergencies. In addition, physicians and medical students, rationally, begin to avoid service lines that are not economically sustainable, exacerbating physician shortages.

“When health insurers began asking physicians to participate in products sold on the new health insurance exchange, CMS did hear that some of the companies would offer rates that were lower than other, existing commercial products. More than a few CMS members raised concerns specific to the narrowing of the networks for these products.  It is our understanding that at least two of the companies who implemented these products have indicated that the narrow network products will not just be offered to consumers on the exchange but also will be part of their larger marketing strategy going forward. While we believe that these reports should be confirmed through interviews with the health insurance companies, the CMS House of Delegates, just last Saturday, passed policy affirming that as networks are narrowed, stronger transparency requirements are necessary to ensure that such networks are built on criteria that account for cost and quality.

“CMS strongly supports additional collaboration between health plans and providers, and looks forward to our continued work bringing high-quality, low cost health care to all Coloradans.”

> Click here to read the story from Aspen Public Radio

Posted in: ASAP | Health System Reform


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