Anthem Blue Cross and Blue Shield’s growing market dominance in Indiana is sparking a backlash from doctors who plan to push
a bill this year in the Indiana General Assembly that would allow physicians to reject patients covered by massive health
insurer.
Anthem Blue Cross and Blue Shield of Indiana ranked highest among health care plans that primarily serve Indiana, but didn’t
even crack the top 100 nationally in a new study.
The St. Francis hospital system and Anthem Blue Cross and Blue Shield of Indiana are haggling over insurance reimbursement
costs. The original demand of Sisters of St. Francis Health Services Inc. would have increased reimbursement amounts $80 million
over three years, Rick Rhodes, an Anthem regional vice president, wrote in an Oct. 30 letter to employers covered by Anthem.
The increase would mean $12 million more in out-of-pocket costs to Anthem customers. But St. Francis claims its request for
an increase only brings it in line with what other hospitals are getting.
Anthem Insurance Co. added nearly 75,000 commercial customers last year, pushing its total up more than 4 percent. Anthem,
a subsidiary of Indianapolis-based WellPoint Inc., now claims a whopping 1.8 million commercial customers in the state. The
trouble is, Anthem’s dominance limits price competition, according to benefits brokers, making it hard for local HMOs such
as M-Plan or even some national players to compete.
Fifteen senior executives have left WellPoint Inc. since November 2004, when the giant health insurer formed through Indianapolis-based
Anthem Inc.’s $16.5 billion acquisition of California-based WellPoint Health Networks Inc. The merger made many of them rich,
work at WellPoint was grueling, and personal commitments called. So they moved on.
A bill moving through the Indiana General Assembly could remove one of the major weapons Anthem Blue Cross and Blue Shield
has used to preserve its market dominion. Senate Bill 114 would forbid health care providers from granting Anthem–or any
other health insurer–so-called “most favored nation” clauses.
