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My Turn: Here’s why Concord Hospital opted out

As reported by the Concord Monitor, Anthem New Hampshire is the only insurance company in the state offering an insurance product on the health care insurance exchange, which is being created as part of the Affordable Care Act (Obamacare). Concord Hospital has decided not to participate as a provider for this product.

It is important to stress that Concord Hospital is a provider for all other Anthem products, and current subscribers to these products may continue to receive their care through our providers and at our hospital. At this time, our decision affects less than 2 percent of people who receive their care from Concord Hospital and its affiliated physicians.

Our decision to not participate in this exchange at this time was not a political statement. We are not opposed to the tenets of the Affordable Care Act or exchanges. However, Anthem was unwilling to negotiate sustainable contract terms, and the reimbursement rates that they offered would ultimately result in us being paid less than what it costs us to provide care. Anthem has indicated that it intends to convert all of its individual policies to the exchange product in 2014, which means that those patients may not be able to access care through Concord Hospital in the future. People who purchase individual polices through Anthem do have options. Concord Hospital is a participating provider for many insurance companies that offer individual plans.

Based on the rates offered by Anthem I feel that participating in the exchange product offered by Anthem could have a detrimental impact on our financial stability and, ultimately, our ability to care for the entire community. (In 2012 we provided more than $38 million of community benefit services). In the past year, I’ve had the opportunity to attend several national meetings. Speakers have consistently stressed caution about committing to rates that could be detrimental to one’s organization. Once you’ve agreed to low rates for one company, how do you ever negotiate for more with that company or any other company? If the insurers decide to move small groups along with individual to the exchange, you could find that you’ve put your organization in financial peril. A healthy organization assures a healthy community.

There are many uncertainties for 2014. It is unclear what the Anthem product will cost consumers. Depending upon that cost, participation in 2014 may be limited, which puts the product at risk. I fully expect we’ll be participating in products offered on the exchange in 2015.

Concord Hospital is working diligently to remain a “value provider.” We continue to work tirelessly to contain medical cost increases. We believe that the overall medical cost for our community is one of the lowest in the state. We’re participating in several shared savings arrangements and achieving financial success with these initiatives. We’re receiving financial incentives from the Medicare Value Based Purchasing Program based on our cost and quality. In addition, we expect to be successful as a participant in the Medicare Shared Savings Program. We’re implementing Lean business practices throughout the enterprise and I’m sure we’re the only hospital in the state that will be seeking ISO9001 Certification in 2014.

Concord Hospital is and will continue to be a leader in the health care industry, but that doesn’t mean we’ll always be the first to sign on to new products. Being a leader is much more about sustainable change and thoughtful participation in the right products.

(Michael B. Green is president and CEO of Concord Hospital.)

Legacy Comments1

Thank you Mr. Green and although may who post here excoriate your hospital, I have always received great care inpatient and outpatient. It is admirable that you provide $38M in care for those who can not afford it and something that those who call your organization "greedy" just have no capacity to comprehend. It must be challenging to manage so many moving parts (something else that the armchair quarterbacks can't fathom) and I commend you on your choice not to cave to Anthem on the issue of exchanges. Thanks for the excellent clarification, I hope that readers will finally understand that in order to maintain the quality of care, excellent service at Concord Hospital that financial decisions are made out of common sense and not "greed". Thank you again!

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