At the end of 2005, Anthem Blue Cross Blue Shield merged with Wellpoint to become the largest health insurance company in the nation. Although that merger didn't remove any competing health insurance companies from the Colorado market, it did give the smaller companies even more of a competitive disadvantage.
The real mergers limiting choice over the last 2 years are when PacifiCare merged with American Medical Security (AMS), United HealthCare merged with Golden Rule, then PacifiCare/AMS merged with United HealthCare/Golden Rule. This will effectively take 4 competing health insurance companies out of the Colorado market and replace them with one super company the size of Anthem/Wellpoint. I'm sure smaller companies like Celtic, Time, IAC, etc, are feeling the pinch and also discovering a need to merge with somebody to stay competitive. Hopefully, Kaiser or Humana won't feel a need to merge with anybody in the near future.
Just think if [Anthem/Wellpoint] and [PacifiCare / AMS/ United/ Golden Rule] were allowed to merge??
The Impact on Doctors
Not only are these mergers taking a toll on the choice health insurance clients have in Colorado and the benefits the competition creates for them, but doctors and hospitals realize a huge disadvantage in their negotiations with these insurance companies. If you belong to a managed care plan like a PPO, the health insurance company will tell you which doctors and hospitals are "in-network" and you will go to those to get the in-network benefits. Before these mergers, United HealthCare (for example) might have come to me (as a doctor) with a contract that would pay me very little for my services. I might have been okay not agreeing to the United HealthCare contract because I would still get plenty of business from being in-network for other companies like PacifiCare, AMS, or Golden Rule. After the merger, the new company of [PacifiCare /AMS /United/ Golden Rule] will have a lot more bargaining power knowing that I might not get enough business without their clients.
2 comments:
It makes you wonder who they care about more, the clients or the stockholders? If only they could all be not for profit like Kaiser and Rocky Mountain Health Plans.
That would be a step in the right direction. Thanks for the comment.
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