by jerry on October 10, 2021
Kaiser Health News reported on health insurance companies finding ways to delay or deny payments to hospitals. There has been longstanding tension between health insurers and hospitals, but the tension seems to have risen to a new level: hospital officials in different states apparently tally billions of dollars in late payments.
It appears that last year, a number of health insurers accelerated payments to hospitals -- it certainly would not have been a good look for them to be accused of playing financial games during a pandemic. Now, though, as those in the US who want to be vaccinated have been vaccinated, attention seems to be turning elsewhere. It seems that at least some insurers are changing policies and procedures (not surprisingly, Anthem officials wrote to blame the changing rules on "excessive prices" on the part of hospitals). There are some missing details, but Anthem's CFO has publicly explained delayed payments as a response to an uncertain environment. It is unclear why a health insurance company facing an uncertain environment entitles them to delay fulfilling obligations outlined in their agreements with hospitals.
In the current landscape of burnt-out providers and general tensions stemming from the pandemic, insurers and providers can hopefully resolve their differences. It is not difficult to imagine how delaying payments would impose enormous operating challenges for the hospitals -- especially at the scale mentioned in the article. Even if the large health insurers are successful in their short-term plans, the antagonism seems likely to invite a retaliatory response from hospitals when they gain the upper hand.