Thursday, January 29, 2009

Massachusetts Health Providers Investigated For Collusion

By Ethan Kalvin

An investigative reporting team for the Boston Globe recently uncovered a possible collusion case involving Blue Cross of Massachusetts and Partners Healthcare. The accusation involves the making of deals off the record in 2000 designed to raise health care rates across the state. Massachusetts Attorney GeneralMartha Coakley has begun an investigation into the matter.

Blue Cross Blue Shield of Massachusetts agreed to pay more money to Partners Healthcare to cover the health care of their policyholders. For the additional money, Partners agreed to seek comparable rate hikes from other insurance companies, thus driving up the consumers insurance rates. The Boston Globe reported that BCBS initially balked at the amount, and only after Partners committed to requesting the same rates from other insurers, did BCBS finally agree to the deal.

Additionally, the Globe Spotlight reporting team discovered that BCBS continues to pay an estimated 30% more to hospitals which are owned by Partners Healthcare than they pay to other hospitals. After nine years, BCBS, the state's largest insurance carrier, is paying an estimated $2 billion yearly to Partners healthcare, the state's biggest health care provider.

The insurance policyholders in Massachusetts are bearing the brunt of the scheme, unfortunately, because much of the money paid to Partners Healthcare comes out of their pockets. The unprecedented collusion between a major health insurance carrier and a major health care provider presents a public interest issue which, thankfully, the attorney general has agreed to take on and investigate.

Partners Healthcare is the biggest operator and owner of hospitals in Massachusetts. They operate several hospitals including Newton-Wellesley Hospital, Brigham and Womens Hospital, and Massachusetts General Hospital. They also serve as a teaching affiliate to Harvard Medical School.

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