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Payer Rankings Don't Tell Providers' Stories

Jacqueline Fellows, for HealthLeaders Media, December 5, 2012

Low rankings don't equal low scores
If payers who ranked high in MGMA-ACMPE's poll received a midrange score, then payers ranking low must have done terribly, right? Not really, though it is a logical conclusion.

Consider the ranking of United Healthcare on the same metric on which Medicare Part B ranked first—overall satisfaction. United was last on the list with MGMA-ACMPE members assigning it an average score of 2.77 on the 1-5 scale, putting it between "moderately dissatisfied" and "neutral."

The score indicates providers may be more apathetic than dissatisfied with payers, though it's not to say there aren't specific complaints.

Don Stumpp, an MGMA-ACMPE member and manager of payer contracting for American Health Network, a group of 200 primary care and multi-specialty physicians, says communication is a big problem.

"Payers rely on communicating through their websites, but practices do not have the time to search websites for answers," says Stumpp. "Unfortunately many payers have cut back on staffing for provider representatives who can come to your practice and help you navigate through issues. They want us [providers] to use their toll-free number that frequently does not resolve the issue.  They need to bring back the reps."

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