Anthem and Premier Have a Food Fight�

Okay, not really, but I couldn�t resist the headline. What did happen, tho, is that the much-ballyhooed arbitration has come to an abrupt � and fruitless � halt. Apparently, after they had met for a grueling day and a half (not counting coffee- or potty-breaks), the two sides �broke off their mediated negotiations without a contract.�

Where does this leave those Anthem insureds whose providers are in the Premier system? Think creek, missing paddle. For most, non-emergency access to Premier services will come with a much higher price tag. For some, there may be no non-emergency coverage at all (this depends on which plan design a given insured has chosen).

As always, there are (at least) two sides to this story. Anthem maintains, and Premier has so far not disputed, that Premier�s costs are significantly higher than other, comparable area provider networks. In essence, Anthem insureds who choose non-Premier providers are subsidizing those who do utilize Premier. OTOH, physicians and hospitals do have costs, and Premier, in the form of Miami Valley hospital, runs the region�s CareFlight service. That can�t come cheap.

So, at least for now, this will continue to be a juggling act between offering affordable health insurance (often, Anthem�s rates are below-market) versus access to a LOT of providers.

There don�t seem to be any winners here.